Provider First Line Business Practice Location Address:
4528 CHAPMAN HWY
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:
37920-4359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-579-3920
Provider Business Practice Location Address Fax Number:
865-579-3963
Provider Enumeration Date:
03/29/2012