Provider First Line Business Practice Location Address:
1900 11TH AVE S
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:
35205-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-322-4272
Provider Business Practice Location Address Fax Number:
205-323-3228
Provider Enumeration Date:
02/16/2007