Organization
REGENERATIVE MEDICAL GROUP INC
Active
Parent organization
REGENERATIVE MEDICAL GROUP INC
Other names
Regenerative Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENERATIVE MEDICAL GROUP INC
Authorized official
BRYN JARALD HENDERSON (OWNER)
(714) 639-4012
Entity
Organization
Contact information
Practice address
2005 N 2ND ST, BOONEVILLE, MS 38829-7728
(662) 416-3306
Mailing address
615 E CHAPMAN AVE, ORANGE, CA 92866-1643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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