Provider First Line Business Practice Location Address:
186 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38320-1618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-584-6135
Provider Business Practice Location Address Fax Number:
731-660-8739
Provider Enumeration Date:
11/23/2011