Provider First Line Business Practice Location Address:
1329 W ANDREW JOHNSON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37814-3728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-254-0129
Provider Business Practice Location Address Fax Number:
423-587-4886
Provider Enumeration Date:
01/16/2008