Provider First Line Business Practice Location Address:
7350 CLINTON HIGHWAY
Provider Second Line Business Practice Location Address:
POWELL CENTER
Provider Business Practice Location Address City Name:
POWELL
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37849-4720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-938-2838
Provider Business Practice Location Address Fax Number:
865-938-3587
Provider Enumeration Date:
07/15/2006