| Az Regenerative Medicne | |
|
16620 N 40th St Ste G2, Phoenix, AZ 85032-3351 | |
| (602) 992-2656 | |
| Not Available |
| Full Name | Az Regenerative Medicne |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 16620 N 40th St Ste G2, Phoenix, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609408194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Jeffrey W Frost |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215081120 PECOS PAC ID: 3678507373 Enrollment ID: I20051116000031 |
| Provider Name | Dana L Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770049173 PECOS PAC ID: 2668701772 Enrollment ID: I20190913001986 |
| Mailing Address | Practice Location Address |
|---|---|
| Az Regenerative Medicne 16620 N 40th St Ste G2, Phoenix, AZ 85032-3351 Ph: (602) 992-2656 | Az Regenerative Medicne 16620 N 40th St Ste G2, Phoenix, AZ 85032-3351 Ph: (602) 992-2656 |
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