Provider First Line Business Practice Location Address:
2701 JEFFERSON 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:
35211-4016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-923-6552
Provider Business Practice Location Address Fax Number:
205-923-9826
Provider Enumeration Date:
11/01/2007