Organization
MESA REGEN GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK PAUL PRUNI DC (MEMBER)
(480) 200-7846
Entity
Organization
Contact information
Practice address
5233 E SOUTHERN AVE STE 103, MESA, AZ 85206-3628
(480) 830-2882
(480) 830-2881
Mailing address
5233 E SOUTHERN AVE STE 103, MESA, AZ 85206-3628
(480) 830-2882
(480) 830-2881
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
07/07/2020
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