Provider First Line Business Practice Location Address:
312 MCMASTER PL
Provider Second Line Business Practice Location Address:
LIBERTY ASSISTED LIVING LLC
Provider Business Practice Location Address City Name:
MARYVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-984-7047
Provider Business Practice Location Address Fax Number:
865-984-8722
Provider Enumeration Date:
07/31/2007