Provider First Line Business Practice Location Address:
4306 ASHEVILLE HWY
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:
37914-3601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-522-2168
Provider Business Practice Location Address Fax Number:
865-522-7116
Provider Enumeration Date:
01/24/2006