Provider First Line Business Practice Location Address:
2916 TAZEWELL PIKE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37918-1873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-281-0202
Provider Business Practice Location Address Fax Number:
865-688-4870
Provider Enumeration Date:
12/26/2006