Provider First Line Business Practice Location Address:
1596 HIGHWAY 33 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW TAZEWELL
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-626-2965
Provider Business Practice Location Address Fax Number:
423-626-2968
Provider Enumeration Date:
07/24/2007