Provider First Line Business Practice Location Address:
2019 HIGHLAND AVENUE
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:
35205-2611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-328-2020
Provider Business Practice Location Address Fax Number:
205-323-7821
Provider Enumeration Date:
07/17/2007