Provider First Line Business Practice Location Address:
2310 HARVEY STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-437-7232
Provider Business Practice Location Address Fax Number:
865-381-8648
Provider Enumeration Date:
10/25/2006