Provider First Line Business Practice Location Address:
205 W MISSION ST
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:
93101-2820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-364-2614
Provider Business Practice Location Address Fax Number:
805-364-2614
Provider Enumeration Date:
06/29/2017