Provider First Line Business Practice Location Address:
2100 CLINCH AVENUE SUITE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-2219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-343-6976
Provider Business Practice Location Address Fax Number:
877-547-9241
Provider Enumeration Date:
07/16/2006