Provider First Line Business Practice Location Address:
2417 3RD AVE S
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:
35233-2514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-326-0050
Provider Business Practice Location Address Fax Number:
205-324-2226
Provider Enumeration Date:
12/14/2005