Provider First Line Business Practice Location Address:
171 MOBILE INFIRMARY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36607-3509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-432-0558
Provider Business Practice Location Address Fax Number:
251-432-0554
Provider Enumeration Date:
05/31/2005