Provider First Line Business Practice Location Address:
2831 HIGHLAND 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:
35205-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-323-2724
Provider Business Practice Location Address Fax Number:
205-714-3195
Provider Enumeration Date:
07/07/2005