Provider First Line Business Practice Location Address:
53 MEMORIAL DR
Provider Second Line Business Practice Location Address:
JAMES H. QUILLEN VAMC, SOCIAL WORK (122)
Provider Business Practice Location Address City Name:
MOUNTAIN HOME
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37684-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-979-2647
Provider Business Practice Location Address Fax Number:
423-979-2720
Provider Enumeration Date:
08/15/2006