Laura  B  Ottaviani    DO
Contract Details
University of Alabama Health Services Foundation, P.C.
Facility name
Provider ID
P000001300
NPI
1992771273
Tax ID
630649108
Effective Date
1/1/1998
Last Updated
3/26/2014
Direct Contract
Yes
Term Date
3/26/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_132
Location Details
Address
1201 11th Avenue South
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059335300 (Phone)
Billing Details
Address
P.O. Box 55309
Birmingham, AL 35255
Billing Phone
2059349999
Specialty Type
Physical Medicine & Rehabilitation
Map
Address