Provider First Line Business Practice Location Address:
1310 24TH AVE SOUTH
Provider Second Line Business Practice Location Address:
PROSTHETICS 3G124 DEPT. OF VETERAN AFFAIRS
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-327-4751
Provider Business Practice Location Address Fax Number:
615-321-6337
Provider Enumeration Date:
08/07/2006