Renewed Vitality | |
560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 | |
(484) 516-2937 | |
(484) 930-0229 |
Full Name | Renewed Vitality |
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Speciality | General Practice |
Location | 560 Van Reed Rd Ste 101, Wyomissing, Pennsylvania |
Authorized Official Name and Position | Rebecca Mcclure (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 4845162937 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Renewed Vitality 560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 Ph: (484) 516-2937 | Renewed Vitality 560 Van Reed Rd Ste 101 Wyomissing PA 19610-1799 Ph: (484) 516-2937 |
NPI Number | 1336765080 |
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Provider Enumeration Date | 06/18/2020 |
Last Update Date | 07/27/2023 |
Medicare PECOS PAC ID | 9133543010 |
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Medicare Enrollment ID | O20200724000829 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336765080 | NPI | - | NPPES |
Provider Name | John M Movassaghi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1457315988 PECOS PAC ID: 0547293193 Enrollment ID: I20050914000474 |
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