Provider First Line Business Practice Location Address:
8035 ROANE MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
HARRIMAN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37748-8334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-374-0600
Provider Business Practice Location Address Fax Number:
865-374-2061
Provider Enumeration Date:
06/18/2012