Provider First Line Business Practice Location Address:
423 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LENOIR CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37772-5640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-271-6600
Provider Business Practice Location Address Fax Number:
865-271-6601
Provider Enumeration Date:
07/29/2006