Provider First Line Business Practice Location Address:
222 MEIGS RD APT 12
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:
93109-1964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-259-6296
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2012