Provider First Line Business Practice Location Address:
2156 GREEN SPRINGS HWY S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205-6808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-251-1251
Provider Business Practice Location Address Fax Number:
205-252-0669
Provider Enumeration Date:
11/20/2006