Provider First Line Business Practice Location Address:
4180 VIA REAL
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-1265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-566-0600
Provider Business Practice Location Address Fax Number:
805-566-0637
Provider Enumeration Date:
08/25/2006