Provider First Line Business Practice Location Address:
1600 7TH AVE SOUTH
Provider Second Line Business Practice Location Address:
AMBULATORY CARE CENTER, SUITE 620
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-939-6270
Provider Business Practice Location Address Fax Number:
205-975-5983
Provider Enumeration Date:
04/18/2012