Provider First Line Business Practice Location Address:
6210 HIGHLAND PLACE WAY
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:
37919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-588-1125
Provider Business Practice Location Address Fax Number:
866-375-0949
Provider Enumeration Date:
07/25/2012