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General NPI Number Information
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NPI Number | 1104747302
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Entity Type | Organization
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Legal Business Name | RENU LONGEVITY PC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 517 S 5TH ST
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City | BISMARCK
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State | ND
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Zip | 58504-5702
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Country | US
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Telephone | 701-751-2229
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Fax | 701-829-7158
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Provider Business Mailing Address
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Address Line | 517 S 5TH ST
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City | BISMARCK
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State | ND
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Zip | 58504-5702
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Country | US
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Telephone | 701-751-2229
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Fax | 701-829-7158
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Authorized Official
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Title or Position | OWNER
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Name | DR. AARON MOOS
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Credential | DC
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Telephone | 701-751-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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