Provider First Line Business Practice Location Address:
1930 ALCOA HWY
Provider Second Line Business Practice Location Address:
PROFESSIONAL BLDG. A, SUITE 240
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-544-9355
Provider Business Practice Location Address Fax Number:
865-544-9168
Provider Enumeration Date:
10/09/2007