# RENUE REGENERATIVE MEDICINE

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

## Provider details

- **NPI number:** 1497349799
- **Authorized official:** MARK VANDEVER D.C. (OWNER)
- **Authorized official phone:** (623) 566-3436

## Contact information

- **Practice address:** 7557 W GREENWAY RD STE 101, PEORIA, AZ 85381-3804
- **Practice address phone:** (623) 566-3436
- **Mailing address:** 7557 W GREENWAY RD STE 101, PEORIA, AZ 85381-3804
- **Mailing address phone:** (623) 566-3436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2021
- **Last updated:** 06/14/2021