Provider First Line Business Practice Location Address:
130 PERIMETER PARK ROAD
Provider Second Line Business Practice Location Address:
SUITE H & I
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37922-2103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-531-0281
Provider Business Practice Location Address Fax Number:
865-531-0283
Provider Enumeration Date:
06/08/2006