Provider First Line Business Practice Location Address:
14 W MICHELTORENA 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:
93101-2510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-493-6118
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/18/2012