Provider First Line Business Practice Location Address:
245 MEDICAL CLINIC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERNON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35592-5232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-695-7531
Provider Business Practice Location Address Fax Number:
205-695-9529
Provider Enumeration Date:
10/03/2006