Provider First Line Business Practice Location Address:
JAMES H. QUILLEN/VA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
CORNER OF SIDNEY AND LAMONT
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-926-1171
Provider Business Practice Location Address Fax Number:
423-979-3435
Provider Enumeration Date:
06/29/2006