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Individual

MARY FONDREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3105 INDEPENDENCE DR, SUITE 105, BIRMINGHAM, AL 35209-4111
(205) 803-2210
Mailing address
3105 INDEPENDENCE DR, SUITE 105, BIRMINGHAM, AL 35209-4111
(205) 803-2210

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1176
AL

Other

Enumeration date
10/10/2016
Last updated
10/10/2016
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