| Regenesis | |
|
300 Randolph Ave Se Huntsville AL 35801-4118 | |
| (256) 715-8193 | |
| Not Available |
| Full Name | Regenesis |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 300 Randolph Ave Se, Huntsville, Alabama |
| Authorized Official Name and Position | Charles Ivy Lee (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2567158193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenesis 300 Randolph Ave Se Huntsville AL 35801-4118 Ph: (256) 715-8193 | Regenesis 300 Randolph Ave Se Huntsville AL 35801-4118 Ph: (256) 715-8193 |
| NPI Number | 1164976825 |
|---|---|
| Provider Enumeration Date | 08/11/2016 |
| Last Update Date | 08/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164976825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 14864 (Alabama) | Primary |
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