Provider First Line Business Practice Location Address:
280 FORT SANDERS WEST BLVD
Provider Second Line Business Practice Location Address:
STE 112
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37922-3352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-218-6210
Provider Business Practice Location Address Fax Number:
865-218-6211
Provider Enumeration Date:
01/16/2007