| Rejuv Bloomington | |
|
405 N Hershey Rd Bloomington IL 61704-3527 | |
| (309) 662-3002 | |
| (309) 263-4611 |
| Full Name | Rejuv Bloomington |
|---|---|
| Speciality | Clinic/center |
| Location | 405 N Hershey Rd, Bloomington, Illinois |
| Authorized Official Name and Position | Shawn Christopher Snider (OWNER) |
| Authorized Official Contact | 3096784342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rejuv Bloomington 405 N Hershey Rd Bloomington IL 61704-3527 Ph: (309) 662-3002 | Rejuv Bloomington 405 N Hershey Rd Bloomington IL 61704-3527 Ph: (309) 662-3002 |
| NPI Number | 1821358383 |
|---|---|
| Provider Enumeration Date | 05/17/2012 |
| Last Update Date | 05/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821358383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036099987 (Illinois) | Primary |
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