Provider First Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL
Provider Second Line Business Practice Location Address:
CCC-121 MED CENTER N, 1161 21ST AVENUE
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-322-3569
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006