Provider First Line Business Practice Location Address:
401 TOWN CREEK RD E STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENOIR CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37772-5612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-271-6160
Provider Business Practice Location Address Fax Number:
865-374-1090
Provider Enumeration Date:
11/07/2005