Provider First Line Business Practice Location Address:
939 E EMERALD AVE
Provider Second Line Business Practice Location Address:
SUITE 705
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37917-4540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-2547
Provider Business Practice Location Address Fax Number:
865-524-0224
Provider Enumeration Date:
03/24/2006