Provider First Line Business Practice Location Address:
AA3228 MEDICAL CTR N
Provider Second Line Business Practice Location Address:
1161 21ST AVENUE SOUTH
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-322-3000
Provider Business Practice Location Address Fax Number:
615-343-8649
Provider Enumeration Date:
10/25/2006