Provider First Line Business Practice Location Address:
710 MERCHANT DRIVE
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:
37912-3868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-687-7246
Provider Business Practice Location Address Fax Number:
865-688-7965
Provider Enumeration Date:
11/30/2007