Provider First Line Business Practice Location Address:
6800 BAUM DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-216-3113
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2007