Provider First Line Business Practice Location Address:
101 FORT SANDERS WEST BLVD
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:
37922-3342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-895-3062
Provider Business Practice Location Address Fax Number:
866-895-3392
Provider Enumeration Date:
08/18/2026