Provider First Line Business Practice Location Address:
309 SAINT LUKES DR
Provider Second Line Business Practice Location Address:
MONTGOMERY EAST FAMILY PRACTICE PC
Provider Business Practice Location Address City Name:
MONTGOMERY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36117-7109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-272-0066
Provider Business Practice Location Address Fax Number:
334-272-5015
Provider Enumeration Date:
07/29/2005