Provider First Line Business Practice Location Address: 
1620 CENTURY CENTER PKWY
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
MEMPHIS
    Provider Business Practice Location Address State Name: 
TN
    Provider Business Practice Location Address Postal Code: 
38134-0181
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
901-385-6000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/17/2010