Provider First Line Business Practice Location Address:
3722 STATE ST UNIT 312
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:
93105-3386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-895-6492
Provider Business Practice Location Address Fax Number:
805-919-5261
Provider Enumeration Date:
10/06/2006