Provider First Line Business Practice Location Address:
444 CLINCHFIELD STREET
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37660-3683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-230-2100
Provider Business Practice Location Address Fax Number:
423-230-2112
Provider Enumeration Date:
12/02/2011