Provider First Line Business Practice Location Address:
2104 E ANDREW JOHNSON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37814-5412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-307-1900
Provider Business Practice Location Address Fax Number:
423-307-1902
Provider Enumeration Date:
08/26/2007