Provider First Line Business Practice Location Address:
260 FORT SANDERS WEST BLVD
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:
37922-3355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-769-4545
Provider Business Practice Location Address Fax Number:
865-769-4501
Provider Enumeration Date:
12/09/2005