Provider First Line Business Practice Location Address:
3000 GETWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-369-8501
Provider Business Practice Location Address Fax Number:
901-369-8503
Provider Enumeration Date:
07/02/2006