Provider First Line Business Practice Location Address:
R-1200 MEDICAL CTR N # 2521
Provider Second Line Business Practice Location Address:
VANDERBILT UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37232-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-322-4669
Provider Business Practice Location Address Fax Number:
615-343-8881
Provider Enumeration Date:
04/18/2006