Provider First Line Business Practice Location Address:
619 19TH ST S
Provider Second Line Business Practice Location Address:
MEB 508, UNIVERSITY OF ALABAMA AT BIRMINGHAM HOSPITAL
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35249-6908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-975-5516
Provider Business Practice Location Address Fax Number:
205-934-0655
Provider Enumeration Date:
06/15/2011