Provider First Line Business Practice Location Address:
425 OLD RICEVILLE RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37303-3072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-551-9200
Provider Business Practice Location Address Fax Number:
423-551-9292
Provider Enumeration Date:
02/09/2026