Provider First Line Business Practice Location Address:
1532 CASTILLO 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:
93101-8508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-913-1117
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2024