Provider First Line Business Practice Location Address:
252 HARRY LANE BLVD STE 202
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:
37923-4912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-338-5384
Provider Business Practice Location Address Fax Number:
865-338-5383
Provider Enumeration Date:
12/08/2006