Provider First Line Business Practice Location Address:
1901 W CLINCH AVE
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:
37916-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-541-1860
Provider Business Practice Location Address Fax Number:
865-541-1861
Provider Enumeration Date:
08/13/2007