Provider First Line Business Practice Location Address:
3049 HIGHWAY 150 S
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-444-4844
Provider Business Practice Location Address Fax Number:
205-444-4846
Provider Enumeration Date:
04/13/2011