Provider First Line Business Practice Location Address:
340 OLD MILL RD SPC 171
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:
93110-3830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-722-8381
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2021