Provider First Line Business Practice Location Address:
1665 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
RYALS PUBLIC HEALTH BUILDING ROOM 327K
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-975-9148
Provider Business Practice Location Address Fax Number:
205-975-2540
Provider Enumeration Date:
08/15/2011