Provider First Line Business Practice Location Address:
5565 MURRAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-682-8437
Provider Business Practice Location Address Fax Number:
901-682-6373
Provider Enumeration Date:
02/21/2007