Provider First Line Business Practice Location Address:
621 W MICHELTORENA ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-4195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-253-2547
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2015