Provider First Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL CTR 1161 21ST
Provider Second Line Business Practice Location Address:
DEPT. OB/ GYN DIVISION OF MFM
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-343-1964
Provider Business Practice Location Address Fax Number:
615-343-8881
Provider Enumeration Date:
10/14/2005