Provider First Line Business Practice Location Address:
601 S CONCORD ST
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-3306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-851-9347
Provider Business Practice Location Address Fax Number:
865-577-6418
Provider Enumeration Date:
07/09/2007