Provider First Line Business Practice Location Address:
6700 BAUM DR
Provider Second Line Business Practice Location Address:
SUITE 14
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-7344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-983-0444
Provider Business Practice Location Address Fax Number:
865-602-2343
Provider Enumeration Date:
01/24/2006