Provider First Line Business Practice Location Address:
1112 E WEISGARBER RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-558-9862
Provider Business Practice Location Address Fax Number:
865-584-3478
Provider Enumeration Date:
12/05/2006