Organization
INTERVENTIONAL ORTHOPEDIC GROUP LLC
Active
Other names
Regenexx Des Moines
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN BUSS (GENERAL MANAGER)
(215) 840-0237
Entity
Organization
Contact information
Practice address
6151 THORNTON AVE STE 200, DES MOINES, IA 50321-2413
(515) 421-4090
(402) 939-0407
Mailing address
6151 THORNTON AVE STE 200, DES MOINES, IA 50321-2413
(515) 421-4090
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659590735
NPI
—
01
—
20155
MEDICARE
—
01
—
56568
MEDICARE
—
Enumeration date
06/30/2021
Last updated
06/30/2021
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