Organization
BLAIR REGENERATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL KEEF WARNER (AUTHORIZED OFFICIAL)
(814) 623-5592
Entity
Organization
Contact information
Practice address
201 HOSPITAL DR STE 2, EVERETT, PA 15537-7019
(814) 623-5592
Mailing address
1381 PLANK RD STE 102, DUNCANSVILLE, PA 16635-8458
(181) 431-7517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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