Provider First Line Business Practice Location Address:
6207 HIGHLAND PLACE WAY
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-4027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-584-6207
Provider Business Practice Location Address Fax Number:
865-934-0080
Provider Enumeration Date:
03/29/2007