Provider First Line Business Practice Location Address:
1240 OLD WEISGARBER RD
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:
37909-2682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-621-4249
Provider Business Practice Location Address Fax Number:
865-381-1371
Provider Enumeration Date:
09/07/2021