Provider First Line Business Practice Location Address:
619 19TH STREET S. UNIVERSITY OF ALABAMA AT BIRMINGHAM
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:
35249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-2373
Provider Business Practice Location Address Fax Number:
205-975-5242
Provider Enumeration Date:
05/05/2018