Provider First Line Business Practice Location Address:
500 FLAT FORK ROAD
Provider Second Line Business Practice Location Address:
MORGAN COUNTY CORRECTIONAL COMPLES
Provider Business Practice Location Address City Name:
WARTBURG
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-346-6641
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2007