Provider First Line Business Practice Location Address:
1830 DE LA VINA ST
Provider Second Line Business Practice Location Address:
APT C
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-2859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-317-5602
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2016