| Life Aligned Regenerative Medical Center Llc | |
|
7290 E Broadway Blvd Ste 106 Tucson AZ 85710-0409 | |
| (520) 731-9595 | |
| (520) 731-9888 |
| Full Name | Life Aligned Regenerative Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 7290 E Broadway Blvd Ste 106, Tucson, Arizona |
| Authorized Official Name and Position | Christopher Charles Cox (OWNER) |
| Authorized Official Contact | 5204448509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Aligned Regenerative Medical Center Llc 7290 E Broadway Blvd Ste 106 Tucson AZ 85710-0409 Ph: (520) 731-9595 | Life Aligned Regenerative Medical Center Llc 7290 E Broadway Blvd Ste 106 Tucson AZ 85710-0409 Ph: (520) 731-9595 |
| NPI Number | 1316438351 |
|---|---|
| Provider Enumeration Date | 05/25/2018 |
| Last Update Date | 08/10/2021 |
| Medicare PECOS PAC ID | 7214286699 |
|---|---|
| Medicare Enrollment ID | O20180817001459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316438351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Kelly A Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396120648 PECOS PAC ID: 1557656071 Enrollment ID: I20160824001840 |
| Provider Name | Andria J Pizzato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801269444 PECOS PAC ID: 1052602364 Enrollment ID: I20161003000247 |
| Provider Name | Kathleen S Prilliman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063467728 PECOS PAC ID: 9830144278 Enrollment ID: I20210420002302 |
| Provider Name | Jennifer Marie Borbon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740866276 PECOS PAC ID: 6709288921 Enrollment ID: I20210712000922 |
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