Provider First Line Business Practice Location Address:
5588 TUCKER RD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF SURGERY
Provider Business Practice Location Address City Name:
COLLEGEDALE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37315-1396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-504-5669
Provider Business Practice Location Address Fax Number:
419-783-4416
Provider Enumeration Date:
03/26/2010