Provider First Line Business Practice Location Address:
6700 BAUM DR STE 22
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:
37919-7334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-253-7740
Provider Business Practice Location Address Fax Number:
865-253-7736
Provider Enumeration Date:
03/30/2022