Provider First Line Business Practice Location Address:
1825 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
1206 SHELBY BLDG
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294-2182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-996-4777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2006