Provider First Line Business Practice Location Address:
2145 HIGHLAND AVE SOUTH
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-933-0320
Provider Business Practice Location Address Fax Number:
205-933-6400
Provider Enumeration Date:
06/12/2012