Provider First Line Business Practice Location Address:
200 MEDICAL CARE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36303-7013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-305-2800
Provider Business Practice Location Address Fax Number:
334-305-2801
Provider Enumeration Date:
07/17/2006