Provider First Line Business Practice Location Address:
5290 OVERPASS RD UNIT 5
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:
93111-2043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-689-7763
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2025