Provider First Line Business Practice Location Address:
6223 HIGHLAND PLACE WAY STE 101
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:
37919-4035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-801-3678
Provider Business Practice Location Address Fax Number:
866-570-5110
Provider Enumeration Date:
05/11/2007