Provider First Line Business Practice Location Address:
CHARLES B BASS CORRECTIONAL COMPLEX
Provider Second Line Business Practice Location Address:
7177 COCKRILL BEND INDUSTRIAL BLVD
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37243-0470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-350-1751
Provider Business Practice Location Address Fax Number:
615-350-1000
Provider Enumeration Date:
03/19/2007