Provider First Line Business Practice Location Address:
109 S NORTHSHORE DR
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-4939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-558-6000
Provider Business Practice Location Address Fax Number:
865-558-9961
Provider Enumeration Date:
12/09/2008