Provider First Line Business Practice Location Address:
1819 CLINCH AVE STE 114
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:
37916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-1631
Provider Business Practice Location Address Fax Number:
865-541-1727
Provider Enumeration Date:
07/28/2008