Regenerative Physical Medicine LLC

NPI #1942923693 in Kingston, Pennsylvania

Provider Information

NPI Number: 1942923693
Entity Type: Organization
Organization Name: Regenerative Physical Medicine LLC
Primary Specialty: General Practice
Enumeration Date: Sep 19, 2022
Last Updated: Sep 19, 2022

Practice Location

Address: 250 PIERCE ST STE 103
City: Kingston
State: Pennsylvania
ZIP Code: 18704-5149
Phone: (570) 287-1110

Authorized Official

Name: TRACY H UNDERDOWN, SOLE MBR
Title: OWNER
Phone: (570) 772-5362

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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