Provider First Line Business Practice Location Address:
200 E BLOUNT AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-1618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-549-4413
Provider Business Practice Location Address Fax Number:
865-549-4414
Provider Enumeration Date:
07/05/2006