Provider First Line Business Practice Location Address:
1618 CUMBERLAND AVENUE
Provider Second Line Business Practice Location Address:
HENSON HALL
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37934-3087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-974-1914
Provider Business Practice Location Address Fax Number:
865-974-3701
Provider Enumeration Date:
09/24/2007