Provider First Line Business Practice Location Address:
6001 JACKSON SQ
Provider Second Line Business Practice Location Address:
SUITE 100 FAMILY HEALTHCARE
Provider Business Practice Location Address City Name:
LA VERGNE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-793-9900
Provider Business Practice Location Address Fax Number:
615-793-9990
Provider Enumeration Date:
10/24/2006