Provider First Line Business Practice Location Address:
125 TOWN CREEK RD E
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
LENOIR CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37772-5690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-986-1400
Provider Business Practice Location Address Fax Number:
865-986-9400
Provider Enumeration Date:
05/05/2011