Provider First Line Business Practice Location Address:
2335 KNOB CREEK RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37604-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-430-9942
Provider Business Practice Location Address Fax Number:
423-212-8700
Provider Enumeration Date:
06/11/2009