Provider First Line Business Practice Location Address:
4117 E EMORY RD
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:
37938-4229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-922-2121
Provider Business Practice Location Address Fax Number:
865-922-0006
Provider Enumeration Date:
03/24/2016