Provider First Line Business Practice Location Address:
244 N PETERS RD
Provider Second Line Business Practice Location Address:
SUITE 221
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37923-4933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-679-6379
Provider Business Practice Location Address Fax Number:
865-694-6138
Provider Enumeration Date:
07/26/2006