Provider First Line Business Practice Location Address:
80 HUMPHREYS CNTR DR
Provider Second Line Business Practice Location Address:
STE 330
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-747-1200
Provider Business Practice Location Address Fax Number:
901-747-1220
Provider Enumeration Date:
06/22/2005