Provider First Line Business Practice Location Address:
2000A SOUTHBRIDGE PKWY
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209-7704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-871-4274
Provider Business Practice Location Address Fax Number:
205-871-4301
Provider Enumeration Date:
05/15/2006