Provider First Line Business Practice Location Address:
10810 PARKSIDE DR
Provider Second Line Business Practice Location Address:
TENNOVA MEDICAL PLAZA 1, SUITE 310
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37934-1979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-212-2282
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006