Renew Medical Spa Llc

NPI 1164739025 - Clinic/Center - 261QM2500X

NPI Details
NPI 1164739025
Enumeration Date 09/13/2010
Last Updated 02/06/2012
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name THERESA M THERESA
Position OWNER
Phone (903) 255-6398
Fax (903) 794-6304
Practice Location
3939 TEXAS BLVD
TEXARKANA TX, 75503-3207, US
Phone (903) 255-6398
Fax (903) 794-6304
Business Location
3939 TEXAS BLVD
TEXARKANA TX, 75503-3207, US
Phone (903) 255-6398
Fax (903) 794-6304
Toxanomy
Taxonomy Code 261QM2500X
License State Arkansas
License Number PA-190
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According to our database, Renew Medical Spa Llc NPI is 1164739025, taxonomy code is 261QM2500X and license number is PA-190, license state is located at Arkansas. Renew Medical Spa Llc physically located at 3939 Texas Blvd, Texarkana TX, 75503-3207. NPI Number 1033115704 has the healthcare provider type.

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1164739025 NPI number is provided on an as is basis without warranty of any kind. 1164739025 is maintained by the National Plan & Provider Enumeration System. The contents of Renew Medical Spa Llc are for informational purposes only.