# INSTITUTE FOR REGENERATIVE MEIDICINE LLC

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

## Provider details

- **NPI number:** 1255811337
- **Authorized official:** JERRY LEECH DC (OWNER)
- **Authorized official phone:** (314) 972-3107

## Contact information

- **Practice address:** 7721 CLAYTON RD, CLAYTON, MO 63117-1301
- **Practice address phone:** (314) 546-6072
- **Practice address fax:** (888) 569-4961
- **Mailing address:** 7721 CLAYTON RD, CLAYTON, MO 63117-1301
- **Mailing address phone:** (314) 546-6072
- **Mailing address fax:** (888) 569-4961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | NULL | Yes |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2018
- **Last updated:** 08/17/2018