Provider First Line Business Practice Location Address:
2013 HIGHLAND AVENUE
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:
37916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-522-3440
Provider Business Practice Location Address Fax Number:
865-637-7195
Provider Enumeration Date:
08/22/2006