Provider First Line Business Practice Location Address:
1135 EUGENIA PL
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-1997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-566-9194
Provider Business Practice Location Address Fax Number:
805-566-9256
Provider Enumeration Date:
08/27/2007