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Rejuventa Medical Corp.
Primary Care Clinic/Center in Centralia, Washington
NPI 1013550987

Rejuventa Medical Corp. is a Primary Care Clinic/Center based in Centralia, WA and is specialized in Primary Care. Rejuventa Medical Corp. practices in Centralia, WA. The NPI Number for Rejuventa Medical Corp. is 1013550987 and holds a License No. (Washington).

The current practice location address for Rejuventa Medical Corp. is 1755 Kresky Ave., Centralia, WA and can be reached out via phone at 360-669-0098 and via fax at 360-669-0121.

Location: 1755 Kresky Ave., Centralia, WA, 98531
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013550987
Provider Name
Rejuventa Medical Corp.
Credential
Provider Entity Type
Organization
Address
1755 Kresky Ave., Centralia, WA, 98531
Phone Number
360-669-0098
Fax Number
360-669-0121
Provider Enumeration Date
10/23/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MD00048810 01 WA WASHINGTON STATE MEDICAL LICENSE
1699792242 01 WA NPI
1013550987 05 WA
institution
Provider Business Practice Location Address Details
Address
1755 Kresky Ave.
City
Centralia
State
Washington
Zip
98531
Phone Number
360-669-0098
Fax Number
360-669-0121
person
Provider Business Mailing Address Details
Address
1755 Kresky Ave.
City
Centralia
State
Washington
Zip
98531
Phone Number
360-669-0098
Fax Number
360-669-0121
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
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Definition
Definition to come...
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