Organization
REGENERATIVE FOOT & ANKLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SHANE MOORE (MANAGER)
(623) 974-0522
Entity
Organization
Contact information
Practice address
13660 N 94TH DR STE F1, PEORIA, AZ 85381-4232
(623) 974-0522
Mailing address
13660 N 94TH DR STE F1, PEORIA, AZ 85381-4232
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
02/22/2018
Last updated
02/10/2020
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