Provider First Line Business Practice Location Address:
3018 SOUTH MALL ROAD
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:
37917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-566-0160
Provider Business Practice Location Address Fax Number:
865-544-1718
Provider Enumeration Date:
02/07/2007