Provider First Line Business Practice Location Address:
116 1/2 NATOMA AVE
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:
93101-3520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-715-0087
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2021