Provider First Line Business Practice Location Address:
1611 SAN ANDRES ST APT B
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:
93101-4183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-252-1606
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2025