Provider First Line Business Practice Location Address:
JAMES H QUILLEN/VAMC
Provider Second Line Business Practice Location Address:
CORNER OF SIDNEY AND LAMONT
Provider Business Practice Location Address City Name:
(JOHNSON CITY) MOUNTAIN HOME
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:
423-979-3428
Provider Enumeration Date:
07/17/2006