Provider First Line Business Practice Location Address:
6215 HUMPREHYS BLVD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-685-7342
Provider Business Practice Location Address Fax Number:
901-767-0423
Provider Enumeration Date:
02/28/2007