Provider First Line Business Practice Location Address:
1760 MILITARY HIGHWAY SO
Provider Second Line Business Practice Location Address:
DR DALE E BOLT
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-921-7806
Provider Business Practice Location Address Fax Number:
205-921-7806
Provider Enumeration Date:
10/23/2006