Provider First Line Business Practice Location Address:
1426 GARDEN ST APT 6
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:
93101-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-933-7820
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2023