Provider First Line Business Practice Location Address:
2729 W ANDREW JOHNSON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37814-3215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-586-3611
Provider Business Practice Location Address Fax Number:
423-586-7454
Provider Enumeration Date:
09/01/2006