Provider First Line Business Practice Location Address:
2018 CLINCH AVENUE SOUTH TOWER 2ND FLOOR
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:
37916-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-525-1425
Provider Business Practice Location Address Fax Number:
877-935-4221
Provider Enumeration Date:
12/30/2014