Provider First Line Business Practice Location Address:
1808 7TH AVENUE SOUTH BOSHELL DIABETES BUILDING 201
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:
35294-1043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-0820
Provider Business Practice Location Address Fax Number:
205-975-8568
Provider Enumeration Date:
03/25/2020