Organization
REGENERATIVE THERAPY OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAKENDRA FULBRIGHT (OWNER)
(770) 906-1316
Entity
Organization
Contact information
Practice address
5040 SNAPFINGER WOODS DRIVE, SUITE 200, STONECREST, GA 30035
(770) 380-6560
(770) 502-6745
Mailing address
5132 PANOLA MILL DR, LITHONIA, GA 30038-2351
(770) 906-1316
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
09/22/2022
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