Provider First Line Business Practice Location Address:
1919 STATE ST STE 102
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:
93101-0406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-324-8989
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2019