Provider First Line Business Practice Location Address:
4414 ASHEVILLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37914-3603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-521-2926
Provider Business Practice Location Address Fax Number:
865-546-7720
Provider Enumeration Date:
08/20/2009