Provider First Line Business Practice Location Address: 
625 STATE ST STE 230
    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: 
93101-3301
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
805-951-8577
    Provider Business Practice Location Address Fax Number: 
805-410-9584
    Provider Enumeration Date: 
07/25/2024