Organization
ILUMINA LIFE CENTER, P.C.
Active
Other names
Regenerative Spine and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FLORENTINA MAYKO (CEO)
(814) 467-4055
Entity
Organization
Contact information
Practice address
211 GRANITE RUN DR STE 221, LANCASTER, PA 17601
(814) 467-4055
Mailing address
247 YORK RD, CARLISLE, PA 17013-3157
(814) 467-4055
(814) 254-4092
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
09/03/2014
Last updated
07/05/2018
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