Provider First Line Business Practice Location Address:
11 PORTOLA LN
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:
93105-4143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-637-8903
Provider Business Practice Location Address Fax Number:
805-617-1825
Provider Enumeration Date:
11/04/2008