Provider First Line Business Practice Location Address:
1865 HONEYSUCKLE RD STE 2
Provider Second Line Business Practice Location Address:
SOUTHEAST ALABAMA MEDICAL CENTER- ALTACARE
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36305-4287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-794-4582
Provider Business Practice Location Address Fax Number:
334-671-9877
Provider Enumeration Date:
08/13/2008