Provider First Line Business Practice Location Address:
923 LAGUNA ST
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-500-0041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2008