Provider First Line Business Practice Location Address:
7945 WOLF RIVER BLVD STE 290
Provider Second Line Business Practice Location Address:
UT MEDICAL GROUP, DEPT OF PLASTIC SURGERY
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-866-8525
Provider Business Practice Location Address Fax Number:
901-302-2525
Provider Enumeration Date:
03/11/2008