Provider First Line Business Practice Location Address:
1800 LEGION DRIVE
Provider Second Line Business Practice Location Address:
DOBYNS-BENNETT HIGH SCHOOL
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-378-8537
Provider Business Practice Location Address Fax Number:
423-378-8534
Provider Enumeration Date:
03/02/2007