Provider First Line Business Practice Location Address:
30 W MISSION ST STE 7
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:
93101-0404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-735-6908
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2023