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General NPI Number Information
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NPI Number | 1932717550
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Entity Type | Organization
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Legal Business Name | REGENTHETICS, LLC
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 903 E STATE HIGHWAY 260 STE 4
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City | PAYSON
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State | AZ
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Zip | 85541-4972
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Country | US
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Telephone | 480-650-9559
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Fax | 928-468-0002
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Provider Business Mailing Address
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Address Line | 903 E STATE HIGHWAY 260 STE 4
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City | PAYSON
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State | AZ
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Zip | 85541-4972
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Country | US
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Telephone | 480-650-9559
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Fax | 928-468-0002
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. BRIAN GABBERT
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Credential | DC
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Telephone | 928-472-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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