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General NPI Number Information
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NPI Number | 1841816600
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Entity Type | Organization
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Legal Business Name | REGENERATIVE HEALTH GROUP PLLC
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 4540 E BASELINE RD STE 113
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City | MESA
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State | AZ
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Zip | 85206-4617
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Country | US
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Telephone | 855-347-3543
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Fax | 833-606-5546
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Provider Business Mailing Address
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Address Line | 4540 E BASELINE RD STE 113
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City | MESA
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State | AZ
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Zip | 85206-4617
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Country | US
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Telephone | 855-347-3543
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Fax | 833-606-5546
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | NEIL MORRIS
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Credential | NMD
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Telephone | 855-347-3543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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