Provider First Line Business Practice Location Address:
1320 OLD WEISGARBER 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:
37909-1291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-584-1054
Provider Business Practice Location Address Fax Number:
865-588-8350
Provider Enumeration Date:
05/28/2009