Provider First Line Business Practice Location Address:
8120 RUTLEDGE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUTLEDGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37861-0406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-828-5222
Provider Business Practice Location Address Fax Number:
865-828-5959
Provider Enumeration Date:
12/12/2006