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General NPI Number Information
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NPI Number | 1659914265
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Entity Type | Organization
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Legal Business Name | R3NEW WELLNESS INC
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Dates
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Enumeration Date | 10/26/2019
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 1145 E DOMINGUEZ ST STE G
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City | CARSON
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State | CA
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Zip | 90746-3547
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Country | US
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Telephone | 714-398-7655
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Fax | 855-447-5526
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Provider Business Mailing Address
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Address Line | 1145 E DOMINGUEZ ST STE G
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City | CARSON
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State | CA
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Zip | 90746-3547
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Country | US
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Telephone |
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Fax | 855-447-5526
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | CRYSTA RICHTER
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Credential |
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Telephone | 424-903-5526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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