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Organization

REJUVENATION WELLNESS LLC

Active
Other names
Vitalogy Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
FARAH TAJ SULTAN MD (OWNER/MEDICAL DIRECTOR)
(205) 413-8599
Entity
Organization

Contact information

Practice address
2704 20TH STREET SOUTH, SUITE 104, HOMEWOOD, AL 35209
(205) 413-8599
(205) 383-2425
Mailing address
2704 20TH STREET SOUTH, SUITE 104, HOMEWOOD, AL 35209
(205) 413-8599
(205) 383-2425

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AL24915
AL

Other

Enumeration date
04/22/2014
Last updated
04/22/2014
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