Organization
BOERNE REGEN AND ANTI-AGING CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEY FRYE DC, APRN, FNP-BC (MANAGING MEMBER)
(956) 763-7767
Entity
Organization
Contact information
Practice address
107 REED RD, BOERNE, TX 78006-8605
(210) 884-2225
Mailing address
29630 DOUBLE EAGLE CIR, FAIR OAKS RANCH, TX 78015-4934
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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