Provider First Line Business Practice Location Address: 
2101 MEDICAL CENTER WAY
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
KNOXVILLE
    Provider Business Practice Location Address State Name: 
TN
    Provider Business Practice Location Address Postal Code: 
37920-3257
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
865-546-9221
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
07/19/2016