Provider First Line Business Practice Location Address:
1108 ROSS CLARK CIR
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36301-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-793-8058
Provider Business Practice Location Address Fax Number:
334-793-0070
Provider Enumeration Date:
02/29/2008