Organization
LUMINOSITY INTEGRATED REJUVENATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SHORT APRN (OWNER)
(606) 793-5077
Entity
Organization
Contact information
Practice address
503 DEPOT ROAD, PAINTSVILLE, KY 41240
(606) 793-5077
Mailing address
PO BOX 55, STAFFORDSVILLE, KY 41256-0055
(606) 793-5077
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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