Provider First Line Business Practice Location Address:
1124 NEW HIGHWAY 52 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMORELAND
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37186-5060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-644-2000
Provider Business Practice Location Address Fax Number:
615-644-2078
Provider Enumeration Date:
11/14/2005