Provider First Line Business Practice Location Address:
6515 CLINTON HWY STE 110
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:
37912-1104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-899-8881
Provider Business Practice Location Address Fax Number:
888-606-4866
Provider Enumeration Date:
12/05/2006