Provider First Line Business Practice Location Address:
MEDICAL CENTER EAST SOUTH TOWER 1215 21ST AVE S
Provider Second Line Business Practice Location Address:
6422
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-8718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-875-2412
Provider Business Practice Location Address Fax Number:
615-936-1225
Provider Enumeration Date:
08/21/2006