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General NPI Number Information
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NPI Number | 1134426331
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Entity Type | Organization
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Legal Business Name | REGENEXX LLC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 6151 THORNTON AVE STE 400
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City | DES MOINES
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State | IA
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Zip | 50321-2408
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Country | US
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Telephone | 515-298-7208
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Fax |
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Provider Business Mailing Address
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Address Line | 6151 THORNTON AVE STE 400
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City | DES MOINES
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State | IA
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Zip | 50321-2408
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Country | US
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Telephone | 515-421-4076
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Fax | 515-809-3726
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Authorized Official
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Title or Position | DIRECTOR CORPORATE ACCOUNTS
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Name | MATTHEW ASHTON PHELPS
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Credential |
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Telephone | 515-633-7128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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