Provider First Line Business Practice Location Address:
2202 MARTIN LUTHER KING JR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37915-1570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-522-6097
Provider Business Practice Location Address Fax Number:
865-540-1615
Provider Enumeration Date:
04/15/2015