# CENTER FOR REGENERATIVE MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Metamorphosis Center for Regenerative Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760929590
- **Authorized official:** VICTORIA KING MD (CMO)
- **Authorized official phone:** (719) 371-0000

## Contact information

- **Practice address:** 113 LATIGO LN STE E, CANON CITY, CO 81212-8114
- **Practice address phone:** (719) 371-0000
- **Practice address fax:** (888) 965-6893
- **Mailing address:** 113 LATIGO LN, CANON CITY, CO 81212-8114
- **Mailing address phone:** (719) 371-0000
- **Mailing address fax:** (888) 965-6893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2017
- **Last updated:** 03/06/2020