Provider First Line Business Practice Location Address:
3001 W ANDREW JOHNSON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORRISTOWN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37814-3614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-587-2450
Provider Business Practice Location Address Fax Number:
423-585-4249
Provider Enumeration Date:
12/19/2006