Provider First Line Business Practice Location Address:
S-3414 MEDICAL CTR N
Provider Second Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-835-1523
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2006