Provider First Line Business Practice Location Address:
16063 HWY 69 SOUTH
Provider Second Line Business Practice Location Address:
MOUNDVILLE MEDICAL CENTER
Provider Business Practice Location Address City Name:
MOUNDVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-371-2267
Provider Business Practice Location Address Fax Number:
205-371-2901
Provider Enumeration Date:
10/24/2005