Provider First Line Business Practice Location Address:
316 RANCHERIA ST APT 2
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:
93101-5439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-893-7323
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2007