Provider First Line Business Practice Location Address:
146E MARKET PLACE BLVD
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:
865-690-7767
Provider Business Practice Location Address Fax Number:
865-690-0120
Provider Enumeration Date:
07/04/2006