Provider First Line Business Practice Location Address:
1515 6TH AVE 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:
35233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-930-3612
Provider Business Practice Location Address Fax Number:
205-918-2333
Provider Enumeration Date:
02/12/2007