Provider First Line Business Practice Location Address:
2340 KNOB CREEK RD STE 704
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37604-2977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-929-9101
Provider Business Practice Location Address Fax Number:
423-434-2032
Provider Enumeration Date:
07/02/2006