Provider First Line Business Practice Location Address:
1504 SPRINGHILL AVE
Provider Second Line Business Practice Location Address:
CHILDREN'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36604-3207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-434-3915
Provider Business Practice Location Address Fax Number:
251-434-3802
Provider Enumeration Date:
07/21/2010