| Regenerative Wellness Center, Llc | |
|
8633 Mexico Rd O Fallon MO 63366-7506 | |
| (636) 272-8888 | |
| (636) 272-7385 |
| Full Name | Regenerative Wellness Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8633 Mexico Rd, O Fallon, Missouri |
| Authorized Official Name and Position | Michael Williams (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6362728891 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Wellness Center, Llc 8633 Mexico Rd O Fallon MO 63366-7506 Ph: (636) 272-8888 | Regenerative Wellness Center, Llc 8633 Mexico Rd O Fallon MO 63366-7506 Ph: (636) 272-8888 |
| NPI Number | 1144694480 |
|---|---|
| Provider Enumeration Date | 11/24/2015 |
| Last Update Date | 11/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144694480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2009009432 (Missouri) | Primary |
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