Provider First Line Business Practice Location Address:
1930 ALCOA HWY
Provider Second Line Business Practice Location Address:
MEDICAL BUILDING A, SUITE 435
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-305-9013
Provider Business Practice Location Address Fax Number:
865-305-6675
Provider Enumeration Date:
01/16/2008