Provider First Line Business Practice Location Address:
311 S WEISGARBER RD STE D
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-7504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-342-7859
Provider Business Practice Location Address Fax Number:
865-558-4363
Provider Enumeration Date:
07/27/2006