# JOINT REGENERATION & ANTI-AGING OF

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073116554
- **Authorized official:** KRISTYN MANZI (OWNER)
- **Authorized official phone:** (770) 683-4495

## Contact information

- **Practice address:** 1601 GEORGIAN PARK STE TERRACE, PEACHTREE CITY, GA 30269-6968
- **Practice address phone:** (770) 683-4495
- **Mailing address:** 1601 GEORGIAN PARK STE TERRACE, PEACHTREE CITY, GA 30269-6968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/18/2020
- **Last updated:** 11/23/2020