Provider First Line Business Practice Location Address:
216 W DE LA GUERRA ST APT 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:
93101-3718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-452-6972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2011