Provider First Line Business Practice Location Address:
540 W PUEBLO ST
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:
93105-4230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-879-0670
Provider Business Practice Location Address Fax Number:
805-898-3611
Provider Enumeration Date:
05/31/2023