Provider First Line Business Practice Location Address:
3008 27TH ST N
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:
35207-4550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-251-1229
Provider Business Practice Location Address Fax Number:
205-251-7528
Provider Enumeration Date:
10/27/2006