Provider First Line Business Practice Location Address:
615 STATE ST UNIT 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:
93101-3301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-234-1620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2025