Provider First Line Business Practice Location Address:
5511 HIGHWAY 280 STE 201
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:
35242-1506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-240-3562
Provider Business Practice Location Address Fax Number:
205-970-9700
Provider Enumeration Date:
12/28/2009