Provider First Line Business Practice Location Address:
2620 MINERAL SPRINGS AVE STE A
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:
37917-1570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-247-4809
Provider Business Practice Location Address Fax Number:
865-247-4927
Provider Enumeration Date:
06/01/2020