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