Provider First Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL CENTER DPT OF
Provider Second Line Business Practice Location Address:
1161 21ST AVENUE SOUTH, MED CENTER N., SUITE CCC-1106
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:
615-343-1187
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2007