Provider First Line Business Practice Location Address:
2305 CHAMBLISS AVE, SW
Provider Second Line Business Practice Location Address:
SKY RIDGE MEDICAL CENTER MAIN
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37311-3899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-339-0300
Provider Business Practice Location Address Fax Number:
423-472-5687
Provider Enumeration Date:
02/08/2012