Provider First Line Business Practice Location Address:
524 ANDREW JOHNSON HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRAWBERRY PLAINS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-933-4149
Provider Business Practice Location Address Fax Number:
865-933-4037
Provider Enumeration Date:
10/24/2024