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Organization

MADISON COUNTY AESTHETICS

Active
Other names
Rejuvenate RX
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KAYLEE FAYE PHELPS (CREDENTIALING SPECIALIST)
(859) 625-4663
Entity
Organization

Contact information

Practice address
236 E MAIN ST, RICHMOND, KY 40475-1628
(859) 582-1087
Mailing address
236 E MAIN ST, RICHMOND, KY 40475-1628
(859) 582-1087

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100571220
KY
Enumeration date
08/06/2024
Last updated
09/23/2024
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