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Organization
RENUVA XTREMITY, LLC
Active
Organization
RENUVA XTREMITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN LUCAS JR. DPM (PODIATRIST)
(901) 309-8898
Entity
Organization
Contact information
Practice address
2900 KIRBY PKWY, STE 5, MEMPHIS, TN 38119
(901) 309-8898
(901) 309-5908
Mailing address
2900 KIRBY PKWY, STE 5, MEMPHIS, TN 38119
(901) 309-8898
(901) 309-5908
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
293D00000X
Physiological Laboratory
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
Other
Enumeration date
11/16/2018
Last updated
04/14/2020
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