Regen Med of Indiana LLC

NPI #1104395680 in Fort Wayne, Indiana

Provider Information

NPI Number: 1104395680
Entity Type: Organization
Organization Name: Regen Med of Indiana LLC
Primary Specialty: General Practice
Enumeration Date: Nov 14, 2018
Last Updated: Nov 14, 2018

Practice Location

Address: 5931 STONEY CREEK DR
City: Fort Wayne
State: Indiana
ZIP Code: 46825-4401
Phone: (260) 482-2206

Authorized Official

Name: TONNA B. CHALFANT
Title: MANAGER
Phone: (260) 482-2206

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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