Provider First Line Business Practice Location Address:
1325 EASTMORELAND AVENUE
Provider Second Line Business Practice Location Address:
STE 245
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-729-3700
Provider Business Practice Location Address Fax Number:
901-729-3750
Provider Enumeration Date:
05/22/2006