Provider First Line Business Practice Location Address:
140 MARKET PLACE BLVD STE E
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:
37922-2337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-212-2211
Provider Business Practice Location Address Fax Number:
833-314-0589
Provider Enumeration Date:
01/10/2007