Provider First Line Business Practice Location Address:
1215 CUMBERLAND AVE
Provider Second Line Business Practice Location Address:
JESSIE HARRIS BUILDING 229
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37996
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-974-7973
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2023