Provider First Line Business Practice Location Address:
1924 ALCOA HWY
Provider Second Line Business Practice Location Address:
SOUTH 6-SOUTH
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-305-8888
Provider Business Practice Location Address Fax Number:
865-305-2514
Provider Enumeration Date:
01/18/2006