Provider First Line Business Practice Location Address:
408 NORTH CEDAR BLUFF RD
Provider Second Line Business Practice Location Address:
SUITE 160
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-690-7531
Provider Business Practice Location Address Fax Number:
865-690-9242
Provider Enumeration Date:
05/11/2007