Provider First Line Business Practice Location Address:
80 HUMPHREYS CENTER DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-578-2538
Provider Business Practice Location Address Fax Number:
901-578-2572
Provider Enumeration Date:
01/02/2013