Provider First Line Business Practice Location Address:
8805 NEW HIGHWAY 68 UNIT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TELLICO PLAINS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37385-3552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-253-3300
Provider Business Practice Location Address Fax Number:
423-253-3947
Provider Enumeration Date:
08/26/2010