Provider First Line Business Practice Location Address:
1400 E 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37917-7712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-5555
Provider Business Practice Location Address Fax Number:
865-524-5563
Provider Enumeration Date:
01/29/2007