Healthcare Provider Details

I. General information

NPI: 1730004276
Provider Name (Legal Business Name): REGENERATIVE HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18209 HILLCREST AVE
OLNEY MD
20832-1422
US

IV. Provider business mailing address

18209 HILLCREST AVE
OLNEY MD
20832-1422
US

V. Phone/Fax

Practice location:
  • Phone: 301-570-9000
  • Fax: 301-570-9055
Mailing address:
  • Phone: 301-570-9000
  • Fax: 301-570-9055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIELLA P. MOSS
Title or Position: OWNER
Credential: D.C.
Phone: 301-570-9000