Provider First Line Business Practice Location Address:
5088 SAN LORENZO DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93111-2614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
58-470-8290
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2012