Provider First Line Business Practice Location Address:
6230 HIGHLAND PLACE WAY
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37919-4036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-584-0276
Provider Business Practice Location Address Fax Number:
865-584-0277
Provider Enumeration Date:
10/19/2006