Provider First Line Business Practice Location Address:
944 OAK RIDGE TURNPIKE
Provider Second Line Business Practice Location Address:
3RD FLOOR, CHEYENNE AMBULATORY CENTER
Provider Business Practice Location Address City Name:
OAK RIDGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-835-3760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2007