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Organization

REGENERATIVE WELLNESS INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CRYSTAL LYNN FRARE RN (VICE PRESIDENT)
(631) 741-0724
Entity
Organization

Contact information

Practice address
23 GREEN ST STE 100A, HUNTINGTON, NY 11743-3336
(631) 304-4385
Mailing address
23 GREEN ST STE 100A, HUNTINGTON, NY 11743-3336
(631) 304-4385

Taxonomy

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

Other

Enumeration date
12/04/2023
Last updated
12/04/2023
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