Provider First Line Business Practice Location Address:
1 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOKEVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38501-4294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-783-2770
Provider Business Practice Location Address Fax Number:
931-525-1176
Provider Enumeration Date:
05/23/2005