Renewed Lifestyles INC

NPI #1063987501 in Maryville, Tennessee

Provider Information

NPI Number: 1063987501
Entity Type: Organization
Organization Name: Renewed Lifestyles INC
Primary Specialty: Clinic/Center - Lithotripsy
Enumeration Date: Oct 11, 2018
Last Updated: Oct 11, 2018

Practice Location

Address: 402 GREENBELT DR
City: Maryville
State: Tennessee
ZIP Code: 37804-5702
Phone: (865) 271-8241

Authorized Official

Name: DAVID TERRY
Title: PHYSCIAN
Phone: (865) 271-8241

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Lithotripsy — Lithotripsy	261QL0400X	Primary

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