Provider First Line Business Practice Location Address:
3960 KNIGHT ARNOLD RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-547-1911
Provider Business Practice Location Address Fax Number:
901-547-1905
Provider Enumeration Date:
11/27/2006