Provider First Line Business Practice Location Address:
3950 VIA REAL SPC 242
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-1268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-279-6644
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2024