Provider First Line Business Practice Location Address:
1731 STATE ST STE 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:
93101-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-329-6976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2023