Provider First Line Business Practice Location Address:
1997 HIGHWAY 51 SOUTH
Provider Second Line Business Practice Location Address:
PROFESSIONAL CARE SERVICES OF WEST TENNESSEE
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-476-8967
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2012