Provider First Line Business Practice Location Address:
8706 BAKER MOUNTAIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPENCER
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38585-5456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-348-5806
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2026