Provider First Line Business Practice Location Address:
1517 E 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:
37814-5485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-839-2550
Provider Business Practice Location Address Fax Number:
423-838-2552
Provider Enumeration Date:
05/03/2013