Provider First Line Business Practice Location Address:
5416 S MIDDLEBROOK PIKE STE A
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:
37921-5980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-484-4134
Provider Business Practice Location Address Fax Number:
865-622-5254
Provider Enumeration Date:
01/20/2025