Provider First Line Business Practice Location Address:
1901 W CLINCH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-481-8044
Provider Business Practice Location Address Fax Number:
865-690-2774
Provider Enumeration Date:
01/29/2007