Provider First Line Business Practice Location Address:
600 HENLEY ST STE 213
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:
37996-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-974-5453
Provider Business Practice Location Address Fax Number:
865-974-1792
Provider Enumeration Date:
11/10/2005