Provider First Line Business Practice Location Address:
UAB MEDICAL CENTER JT N412
Provider Second Line Business Practice Location Address:
619 19TH SOUTH
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35249-0293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-3138
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006