Provider First Line Business Practice Location Address:
260 16TH AVE
Provider Second Line Business Practice Location Address:
SUITE 116 GENUINE PODIATRY SERVICES
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-775-5400
Provider Business Practice Location Address Fax Number:
423-570-0222
Provider Enumeration Date:
09/02/2006