Provider First Line Business Practice Location Address:
1317 4TH 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:
35233-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-322-1808
Provider Business Practice Location Address Fax Number:
205-322-1851
Provider Enumeration Date:
03/08/2007