Provider First Line Business Practice Location Address:
613 A WATAUGA STREET
Provider Second Line Business Practice Location Address:
DR ROBERT W PANNELL
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-246-1963
Provider Business Practice Location Address Fax Number:
423-246-6452
Provider Enumeration Date:
11/10/2006