Provider First Line Business Practice Location Address:
126 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OZARK
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36360-2018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-793-8087
Provider Business Practice Location Address Fax Number:
334-793-8191
Provider Enumeration Date:
04/26/2006