Provider First Line Business Practice Location Address:
919 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37683-1042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-727-7800
Provider Business Practice Location Address Fax Number:
423-727-2498
Provider Enumeration Date:
01/07/2008