Provider First Line Business Practice Location Address:
2723 E MAGNOLIA AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37914-5247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-525-9626
Provider Business Practice Location Address Fax Number:
888-678-4908
Provider Enumeration Date:
07/02/2009