# WEST GEORGIA REGENERATIVE MEDICINE LLC

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

## Provider details

- **NPI number:** 1629555172
- **Authorized official:** DR. MICHAEL HANIOTIS DC (AUTHORIZED OFFICIAL/PARTNER)
- **Authorized official phone:** (762) 204-4103

## Contact information

- **Practice address:** 3624 EDGEWOOD RD STE B, COLUMBUS, GA 31907
- **Practice address phone:** (762) 204-4103
- **Mailing address:** 3624 EDGEWOOD RD STE B, COLUMBUS, GA 31907-8238
- **Mailing address phone:** (762) 204-4103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 07/26/2018
- **Last updated:** 08/07/2025