Provider First Line Business Practice Location Address:
1215 21ST AVE S STE 9302
Provider Second Line Business Practice Location Address:
MEDICAL CENTER EAST, SOUTH TOWER
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-936-4699
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2008