| NPI | 1356812895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AWILDA MARRERO LABONNE CEO 423-648-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 208600000X Surgery |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2020-12-17 |