Provider First Line Business Practice Location Address:
5724 HIGHWAY 280 E
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:
35242-6818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-408-4800
Provider Business Practice Location Address Fax Number:
205-582-1041
Provider Enumeration Date:
10/24/2016