Provider First Line Business Practice Location Address:
4690 CARPINTERIA AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-1870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-684-5012
Provider Business Practice Location Address Fax Number:
805-684-7225
Provider Enumeration Date:
01/05/2007