Provider First Line Business Practice Location Address:
6700 BAUM DR
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-588-0535
Provider Business Practice Location Address Fax Number:
865-584-0963
Provider Enumeration Date:
03/26/2007