Provider First Line Business Practice Location Address:
3000 N CENTRAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37917-5117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-546-9431
Provider Business Practice Location Address Fax Number:
865-546-7960
Provider Enumeration Date:
01/30/2007