Provider First Line Business Practice Location Address:
1240 OLD WEISGARBER RD STE B
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:
37909-2683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-685-4265
Provider Business Practice Location Address Fax Number:
865-862-8983
Provider Enumeration Date:
10/13/2008