Provider First Line Business Practice Location Address:
UNIVERSITY OF ALABAMA AT BIRMINGHAM DEPT OF
Provider Second Line Business Practice Location Address:
176F RM 5325, 619 19TH STREET S
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35249-7333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-996-3310
Provider Business Practice Location Address Fax Number:
205-975-6411
Provider Enumeration Date:
08/07/2006