Provider First Line Business Practice Location Address:
80 HUMPHREYS CTR
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-747-2229
Provider Business Practice Location Address Fax Number:
901-747-4446
Provider Enumeration Date:
09/13/2006