Provider First Line Business Practice Location Address:
2019 HIGHLAND AVE 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:
35205-3801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-328-2020
Provider Business Practice Location Address Fax Number:
205-918-9096
Provider Enumeration Date:
02/23/2006