Provider First Line Business Practice Location Address:
2451 UNIVERSITY HOSPITAL DR RM 714
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36617-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-434-3915
Provider Business Practice Location Address Fax Number:
251-415-1387
Provider Enumeration Date:
08/08/2011