Provider First Line Business Practice Location Address:
689 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LENOIR CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37772-5642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-986-8121
Provider Business Practice Location Address Fax Number:
865-986-8124
Provider Enumeration Date:
08/14/2006