Provider First Line Business Practice Location Address:
2000 6TH AVE S FL CLINIC1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233-2110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-801-8705
Provider Business Practice Location Address Fax Number:
205-801-7880
Provider Enumeration Date:
04/30/2020