Provider First Line Business Practice Location Address:
3960 KNIGHT ARNOLD RD
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38118-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-365-6709
Provider Business Practice Location Address Fax Number:
901-369-8129
Provider Enumeration Date:
09/30/2011