Organization
INDIANA REGENERATIVE MEDICINE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON PEACHEE DC (TIN OWNER)
(317) 653-4503
Entity
Organization
Contact information
Practice address
8202 CLEARVISTA PKWY STE 9D, INDIANAPOLIS, IN 46256-1457
(317) 653-4503
Mailing address
8202 CLEARVISTA PKWY STE 9D, INDIANAPOLIS, IN 46256-1457
(317) 578-7544
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2019
Last updated
04/22/2020
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