Provider First Line Business Practice Location Address:
50 MEDICAL PARK EAST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-545-9530
Provider Business Practice Location Address Fax Number:
205-545-9530
Provider Enumeration Date:
12/02/2005