Provider First Line Business Practice Location Address:
920 MADISON AVENUE, UNIVERSITY OF TENNESSEE
Provider Second Line Business Practice Location Address:
SUITE 447
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-478-0589
Provider Business Practice Location Address Fax Number:
901-478-0582
Provider Enumeration Date:
06/12/2025