Provider First Line Business Practice Location Address:
932 SPRING CREEK RD
Provider Second Line Business Practice Location Address:
EAST RIDGE EYE CENTER
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37412-3910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-894-1453
Provider Business Practice Location Address Fax Number:
423-899-8022
Provider Enumeration Date:
04/19/2007