Provider First Line Business Practice Location Address:
5505 CREEKWOOD PARK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENOIR CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37772-1201
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:
08/16/2012