Provider First Line Business Practice Location Address:
6965 CUMBERLAND GAP PARKWAY
Provider Second Line Business Practice Location Address:
LINCOLN MEMORIAL UNIVERSITY
Provider Business Practice Location Address City Name:
HARROGATE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-313-3828
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2011