Provider First Line Business Practice Location Address:
1120 E WEISGARBER RD
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-584-2071
Provider Business Practice Location Address Fax Number:
865-584-2165
Provider Enumeration Date:
09/12/2006