Provider First Line Business Practice Location Address:
2017 STONEBROOK PLACE
Provider Second Line Business Practice Location Address:
FRONTIER HEALTH FRONTIER INDUSTRIES
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-224-1412
Provider Business Practice Location Address Fax Number:
423-224-1418
Provider Enumeration Date:
03/20/2007