# RENUVA HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** RENUVA BACK AND PAIN CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801155486
- **Authorized official:** DR. MICHAEL GREEN D.C. (ASSOCIATE D.C.)
- **Authorized official phone:** (913) 667-2829

## Contact information

- **Practice address:** 4400 COLLEGE BLVD STE 150, OVERLAND PARK, KS 66211-2326
- **Practice address phone:** (913) 667-2298
- **Mailing address:** 4400 COLLEGE BLVD STE 150, OVERLAND PARK, KS 66211-2326
- **Mailing address phone:** (913) 667-2298
- **Mailing address fax:** (816) 525-9052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2012
- **Last updated:** 12/12/2023