Provider First Line Business Practice Location Address:
1995 HWY 51 SOUTH
Provider Second Line Business Practice Location Address:
BAPTIST MEMORIAL HOSPITAL TIPTON
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-476-2621
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2005