Organization
JOINT REGENERATION AND ANTI-AGING OF NEWNAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTIN MANZI (MBR)
(410) 507-5333
Entity
Organization
Contact information
Practice address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5544
Mailing address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5544
(855) 552-3776
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
—
—
163WW0000X
Wound Care Registered Nurse
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
11/04/2019
Last updated
04/25/2020
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