Provider First Line Business Practice Location Address:
1726 SAN ANDRES ST
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:
93101-4013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-596-4139
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/13/2019