Provider First Line Business Practice Location Address:
144 MEDICAL CENTER DR #B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COPPERHILL
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37317-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-496-9214
Provider Business Practice Location Address Fax Number:
423-496-7809
Provider Enumeration Date:
03/01/2006