Provider First Line Business Practice Location Address:
800 NEW LAKE ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SPRING CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37381-5460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-365-9000
Provider Business Practice Location Address Fax Number:
423-365-9077
Provider Enumeration Date:
06/05/2008