Provider First Line Business Practice Location Address:
510 DE LA VINA
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:
93101-3456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-965-9556
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2012