Provider First Line Business Practice Location Address:
8375 HWY 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-635-7218
Provider Business Practice Location Address Fax Number:
423-458-6908
Provider Enumeration Date:
04/24/2025