Provider First Line Business Practice Location Address:
11201 WEST POINT DR
Provider Second Line Business Practice Location Address:
SUITE 102 FARRAGUT FAMILY PRACTICE
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37934-2834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-675-1953
Provider Business Practice Location Address Fax Number:
865-675-0877
Provider Enumeration Date:
06/07/2006