Provider First Line Business Practice Location Address:
EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE
Provider Second Line Business Practice Location Address:
OF MEDICINE DEPARTMENT OF ACADEMIC AFFAIRS
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37614-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-439-2423
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/13/2012