Provider First Line Business Practice Location Address:
619 19TH ST S
Provider Second Line Business Practice Location Address:
JEFFERSON TOWER, DEPT OF RADIOLOGY
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35249-6830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-3166
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2008