Provider First Line Business Practice Location Address:
2100 W CLINCH AVE
Provider Second Line Business Practice Location Address:
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:
37916-2219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-637-8481
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2005