Organization
AWILDA MARRERO LABONNE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AWILDA MARRERO LABONNE PA-C (CEO)
(423) 648-2273
Entity
Organization
Contact information
Practice address
13 W KENT ST STE 103, CHATTANOOGA, TN 37405-9913
(423) 648-2273
(423) 206-4625
Mailing address
13 W KENT ST STE 103, CHATTANOOGA, TN 37405-9913
(423) 648-2273
(423) 206-4625
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q046052
—
TN
Enumeration date
12/10/2018
Last updated
12/17/2020
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