Provider First Line Business Practice Location Address:
1030 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
VA HOSP, RADIATION ONCOLOGY DEPT.
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-577-7285
Provider Business Practice Location Address Fax Number:
901-577-7428
Provider Enumeration Date:
08/29/2006