Provider First Line Business Practice Location Address:
120 GREEN SPRINGS AVE SW
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:
35211-3914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-836-8588
Provider Business Practice Location Address Fax Number:
205-321-1239
Provider Enumeration Date:
05/01/2009