Provider First Line Business Practice Location Address:
393 WALLACE RD
Provider Second Line Business Practice Location Address:
STE 104A INTERNAL MEDICINE LP
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-331-4104
Provider Business Practice Location Address Fax Number:
615-331-9962
Provider Enumeration Date:
01/08/2007