Provider First Line Business Practice Location Address:
7900 JOHNSON DRIVE
Provider Second Line Business Practice Location Address:
BOX 98
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-251-2836
Provider Business Practice Location Address Fax Number:
865-251-2435
Provider Enumeration Date:
08/03/2011