Provider First Line Business Practice Location Address:
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Provider Second Line Business Practice Location Address:
1900 UNIVERSITY BLVD THT 629C
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-937-4804
Provider Business Practice Location Address Fax Number:
205-934-7742
Provider Enumeration Date:
05/10/2023