Organization
ILUMINA LIFE CENTER, P.C.
Active
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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