Provider First Line Business Practice Location Address:
6325 HUMPHREYS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-522-7700
Provider Business Practice Location Address Fax Number:
901-522-2600
Provider Enumeration Date:
11/04/2009