Provider First Line Business Practice Location Address:
COMMUNITY CARE BUILDING 908 20TH STREET
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:
35294-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-1917
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2008