Provider First Line Business Practice Location Address:
135 WEST RAVINE ROAD
Provider Second Line Business Practice Location Address:
WELLMONT HOLSTON VALLEY MEDICAL CENTER INPATIENT PHARM.
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-431-4291
Provider Business Practice Location Address Fax Number:
423-224-6865
Provider Enumeration Date:
10/06/2008