Provider First Line Business Practice Location Address:
6869 5TH AVENUE SOUTH
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:
35212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-833-9000
Provider Business Practice Location Address Fax Number:
205-838-4078
Provider Enumeration Date:
06/28/2006