Provider First Line Business Practice Location Address:
5112 SCHUBERT RD
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:
37912-3832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-688-1220
Provider Business Practice Location Address Fax Number:
865-577-0688
Provider Enumeration Date:
11/08/2006