Provider First Line Business Practice Location Address:
1512 DE LA VINA 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:
93101-8591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-965-5029
Provider Business Practice Location Address Fax Number:
805-681-5350
Provider Enumeration Date:
09/17/2008