Provider First Line Business Practice Location Address:
920 18TH ST S
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-933-8373
Provider Business Practice Location Address Fax Number:
205-278-8718
Provider Enumeration Date:
10/01/2008