Provider First Line Business Practice Location Address:
817 PRINCETON AVE SW
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35211-1349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-780-8980
Provider Business Practice Location Address Fax Number:
205-785-1554
Provider Enumeration Date:
09/20/2006