Provider First Line Business Practice Location Address:
1323 EAST WOOD STREET
Provider Second Line Business Practice Location Address:
EAST WOOD CLINIC
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-642-2011
Provider Business Practice Location Address Fax Number:
731-644-2758
Provider Enumeration Date:
07/07/2006