Provider First Line Business Practice Location Address:
VINE MIDDLE SCHOOL CLINIC
Provider Second Line Business Practice Location Address:
1807 MARTIN LUTHER KING AVENUE
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-594-5078
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2007