Provider First Line Business Practice Location Address:
2180 UNION AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104-4205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-276-2200
Provider Business Practice Location Address Fax Number:
901-276-6828
Provider Enumeration Date:
03/08/2012