Provider First Line Business Practice Location Address:
1825 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
SHELBY 401
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-1522
Provider Business Practice Location Address Fax Number:
205-975-6352
Provider Enumeration Date:
02/28/2007