Provider First Line Business Practice Location Address:
901 E CENTRAL AVE
Provider Second Line Business Practice Location Address:
MEDICAL CENTER PHARMACY
Provider Business Practice Location Address City Name:
LAFOLLETTE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-562-8456
Provider Business Practice Location Address Fax Number:
423-562-3167
Provider Enumeration Date:
04/03/2007