Provider First Line Business Practice Location Address:
2451 UNIVERSITY HOSPITAL DR FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36617-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-471-7790
Provider Business Practice Location Address Fax Number:
251-471-7096
Provider Enumeration Date:
08/20/2006