Provider First Line Business Practice Location Address:
2100 COUNTY SERVICES DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PELHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35124-6150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-621-6070
Provider Business Practice Location Address Fax Number:
205-755-8882
Provider Enumeration Date:
12/04/2006