Provider First Line Business Practice Location Address:
1400 6TH 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:
35233-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-933-9110
Provider Business Practice Location Address Fax Number:
205-930-1156
Provider Enumeration Date:
02/16/2006