Provider First Line Business Practice Location Address:
7524 KINGSTON PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-588-2215
Provider Business Practice Location Address Fax Number:
865-588-2801
Provider Enumeration Date:
01/29/2007