Organization
INFINITE REGENERATIVE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON WELLS DC (SECRETARY)
(805) 548-8877
Entity
Organization
Contact information
Practice address
3565 S HIGUERA ST, SAN LUIS OBISPO, CA 93401-7339
(805) 548-8877
(805) 548-0055
Mailing address
3565 S HIGUERA ST, SAN LUIS OBISPO, CA 93401-7339
(805) 548-8877
(805) 548-0055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831249945
NPI
CA
01
—
1992783302
NPI
CA
01
—
DC20839
LIC
CA
01
—
G58508
LIC
CA
Enumeration date
01/31/2019
Last updated
07/02/2020
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