Provider First Line Business Practice Location Address:
2429 BATH 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:
93105-5337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-705-1924
Provider Business Practice Location Address Fax Number:
805-687-2442
Provider Enumeration Date:
04/09/2015