Provider First Line Business Practice Location Address:
22 W MISSION ST STE C
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:
93101-2450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-687-8021
Provider Business Practice Location Address Fax Number:
805-335-8903
Provider Enumeration Date:
05/28/2018