Provider First Line Business Practice Location Address:
2426 MINERAL SPRINGS AVE
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:
37917-1553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-687-7227
Provider Business Practice Location Address Fax Number:
865-687-7244
Provider Enumeration Date:
12/26/2006