Provider First Line Business Practice Location Address:
7815 B OAK RIDGE HWY
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:
37931-2314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
30-720-0899
Provider Business Practice Location Address Fax Number:
865-560-8862
Provider Enumeration Date:
10/05/2006