Provider First Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL CENTER, CCC-1108: MCN
Provider Second Line Business Practice Location Address:
21ST AVE SOUTH
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-2675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-343-8516
Provider Business Practice Location Address Fax Number:
615-343-6531
Provider Enumeration Date:
08/17/2006