Provider First Line Business Practice Location Address:
410 N CEDAR BLUFF RD
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37923-3623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-342-8900
Provider Business Practice Location Address Fax Number:
865-691-0843
Provider Enumeration Date:
09/15/2006