Provider First Line Business Practice Location Address:
437 GARLAND BRANCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATAUGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-926-9800
Provider Business Practice Location Address Fax Number:
423-926-9833
Provider Enumeration Date:
04/01/2009