Provider First Line Business Practice Location Address:
412 DEVONIA ST
Provider Second Line Business Practice Location Address:
ROANE MEDICAL CENTER
Provider Business Practice Location Address City Name:
HARRIMAN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37748-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-985-7234
Provider Business Practice Location Address Fax Number:
865-291-3224
Provider Enumeration Date:
09/15/2006