Provider First Line Business Practice Location Address:
2214 WHITE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-2551
Provider Business Practice Location Address Fax Number:
865-522-3550
Provider Enumeration Date:
01/23/2007