Provider First Line Business Practice Location Address:
816 CACIQUE 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:
93103-3622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
820-229-9714
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2022