Provider First Line Business Practice Location Address:
323 PAUL BRYANT DR.
Provider Second Line Business Practice Location Address:
ATHLETIC TRAINING ROOM
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-348-3612
Provider Business Practice Location Address Fax Number:
205-348-3664
Provider Enumeration Date:
10/08/2012