Provider First Line Business Practice Location Address:
700 UNIVERSITY BLVD E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35401-2028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-348-7131
Provider Business Practice Location Address Fax Number:
205-348-1845
Provider Enumeration Date:
02/22/2008