Provider First Line Business Practice Location Address:
120 BARRANCA AVE APT B
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:
93109-4203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-360-0797
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/18/2010