Provider First Line Business Practice Location Address:
110 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLANTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35045-2332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-755-5933
Provider Business Practice Location Address Fax Number:
205-755-8882
Provider Enumeration Date:
02/20/2009