Provider First Line Business Practice Location Address:
348 GORDON PALMER HALL HACKBERRY LANE
Provider Second Line Business Practice Location Address:
THE UNIVERSITY OF ALABAMA
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35487-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-348-9891
Provider Business Practice Location Address Fax Number:
205-348-7520
Provider Enumeration Date:
10/10/2007