Provider First Line Business Practice Location Address:
206 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-794-8797
Provider Business Practice Location Address Fax Number:
334-479-0658
Provider Enumeration Date:
07/11/2006