Provider First Line Business Practice Location Address:
2425 MARTIN LUTHER KING JR AVE
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:
37915-1621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-208-5254
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2026