Provider First Line Business Practice Location Address:
700 19TH ST S
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:
35233-1927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-253-5995
Provider Business Practice Location Address Fax Number:
205-726-2669
Provider Enumeration Date:
10/23/2006