FULL LIFE REGENERATION PC NPI 1609464395

NPI Information

FULL LIFE REGENERATION, PC is a multi-specialty clinic center in Florence, AL. FULL LIFE REGENERATION, PC NPI is 1609464395. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

117 RENAISSANCE ST
FLORENCE, AL
ZIP 35630-207
Phone: (256) 765-0002
Fax: (256) 765-0022

The provider's authorized official is Tyler Melson .
The authorized official title is Owner and has the following contact phone number (256) 765-0002.

The enumeration date for this NPI number is 1/7/2021 and was last updated on 5/26/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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