Provider First Line Business Practice Location Address:
1225 COAST VILLAGE RD STE C
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:
93108-3714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-364-2826
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2020