Provider First Line Business Practice Location Address:
219 NORTH AVE
Provider Second Line Business Practice Location Address:
STE 201, HEALTHCARE SERVICES INC
Provider Business Practice Location Address City Name:
LA FOLLETTE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37766-2732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-566-1314
Provider Business Practice Location Address Fax Number:
423-566-2466
Provider Enumeration Date:
12/29/2005