Provider First Line Business Practice Location Address:
3428 OLD COLUMBIANA RD
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:
35226-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-824-7171
Provider Business Practice Location Address Fax Number:
205-824-7179
Provider Enumeration Date:
07/26/2006