Provider First Line Business Practice Location Address:
2320 BATH ST
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93105-4339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-569-1164
Provider Business Practice Location Address Fax Number:
805-569-1094
Provider Enumeration Date:
07/18/2012