# BLAIR REGENERATIVE MEDICINE LLC

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

## Provider details

- **NPI number:** 1649882275
- **Authorized official:** DARRYL KEEF WARNER (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (814) 623-5592

## Contact information

- **Practice address:** 201 HOSPITAL DR STE 2, EVERETT, PA 15537-7019
- **Practice address phone:** (814) 623-5592
- **Mailing address:** 1381 PLANK RD STE 102, DUNCANSVILLE, PA 16635-8458
- **Mailing address phone:** (181) 431-7517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2020
- **Last updated:** 08/17/2020