Provider First Line Business Practice Location Address:
417 HOLLY ST
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:
37927-3730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-922-1400
Provider Business Practice Location Address Fax Number:
865-922-0928
Provider Enumeration Date:
06/15/2006