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Organization
SPRINGS REJUVENATION LLC
Active
Organization
SPRINGS REJUVENATION LLC
Active
Other names
Springs Rejuvenation
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA REEDER BSHA, CCMA, CBCS (PRACTICE ADMINISTRATOR)
(470) 589-7120
Entity
Organization
Contact information
Practice address
420 E 3RD ST STE 705, LOS ANGELES, CA 90013-1646
(404) 780-5617
Mailing address
4411 SUWANEE DAM RD STE 440, SUWANEE, GA 30024-8706
(470) 589-7120
(844) 350-6954
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
—
NULL
207PS0010X
Sports Medicine (Emergency Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
04/17/2023
Last updated
01/17/2024
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