Provider First Line Business Practice Location Address:
280 FORT SANDERS WEST BLVD
Provider Second Line Business Practice Location Address:
SUITE 117
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37922-3351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-539-6030
Provider Business Practice Location Address Fax Number:
865-539-6768
Provider Enumeration Date:
01/18/2007