Provider First Line Business Practice Location Address:
200 HWY 52 BYPASS WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37083-1727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-666-5600
Provider Business Practice Location Address Fax Number:
615-666-8400
Provider Enumeration Date:
11/06/2006