Provider First Line Business Practice Location Address:
2620 MINERAL SPRINGS AVENUE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-688-5700
Provider Business Practice Location Address Fax Number:
865-688-2342
Provider Enumeration Date:
11/01/2006