Provider First Line Business Practice Location Address:
1161 21ST AVE S
Provider Second Line Business Practice Location Address:
A-2200 MEDICAL CENTER NORTH
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-2582
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-322-8972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2006