Renovus Medical Spa

NPI 1134408214 - Point of Service - 305S00000X

NPI Details
NPI 1134408214
Enumeration Date 08/08/2011
Last Updated 08/08/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name KATHY KATHY
Position OWNER
Phone (423) 207-0154
Fax
Practice Location
405 ROY MARTIN RD
STE 104
GRAY TN, 37615-2551, US
Phone (423) 207-0154
Fax
Business Location
405 ROY MARTIN RD
STE 104
GRAY TN, 37615-2551, US
Phone (423) 207-0154
Fax
Toxanomy
Taxonomy Code 305S00000X
License State Tennessee
License Number 17509
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According to our database, Renovus Medical Spa NPI is 1134408214, taxonomy code is 305S00000X and license number is 17509, license state is located at Tennessee. Renovus Medical Spa physically located at 405 Roy Martin Rd, Gray TN, 37615-2551. NPI Number 1033115704 has the healthcare provider type.

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1134408214 NPI number is provided on an as is basis without warranty of any kind. 1134408214 is maintained by the National Plan & Provider Enumeration System. The contents of Renovus Medical Spa are for informational purposes only.