Provider First Line Business Practice Location Address:
5968 KNIGHT ARNOLD ROAD EXT
Provider Second Line Business Practice Location Address:
SUITE 300 A
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38115-3251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-366-6754
Provider Business Practice Location Address Fax Number:
901-366-6756
Provider Enumeration Date:
03/11/2008