Provider First Line Business Practice Location Address:
650 UNIVERSITY BLVD E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35401-2016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-977-2542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2026