Provider First Line Business Practice Location Address:
232 E CHURCHWELL AVE
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:
37917-5419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-540-6243
Provider Business Practice Location Address Fax Number:
865-313-2580
Provider Enumeration Date:
07/19/2019