Provider First Line Business Practice Location Address:
303 HIGH ST N
Provider Second Line Business Practice Location Address:
TN DEPT. OF HEALTH
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37030-1429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-735-0242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/06/2007