Provider First Line Business Practice Location Address:
3695 LA ENTRADA
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:
93105-4510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-809-6902
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2012