Provider First Line Business Practice Location Address: 
315 W HALEY ST
    Provider Second Line Business Practice Location Address: 
102
    Provider Business Practice Location Address City Name: 
SANTA BARBARA
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
93101-3471
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
805-966-3310
    Provider Business Practice Location Address Fax Number: 
805-966-5582
    Provider Enumeration Date: 
11/07/2006