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General NPI Number Information
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NPI Number | 1770205379
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Entity Type | Organization
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Legal Business Name | REJUVENATE HEALTH MEDICAL, LLC
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 53 PERSIMMONS ST STE 105
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City | BLUFFTON
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State | SC
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Zip | 29910-7656
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Country | US
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Telephone | 843-757-7836
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Fax | 843-757-7837
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Provider Business Mailing Address
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Address Line | 53 PERSIMMONS ST
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City | BLUFFTON
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State | SC
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Zip | 29910-7655
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Country | US
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Telephone | 843-757-7836
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Fax | 843-757-7837
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Authorized Official
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Title or Position | CONTACT
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Name | JENNY NEWCOMB
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Credential |
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Telephone | 631-736-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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