Provider First Line Business Practice Location Address:
2100 RED ROSE WAY APT E
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:
93109-1261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-391-2448
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2022