NPI 1104395680

Regen Med of Indiana LLC

Organisation General Practice Physician Fort Wayne, IN

Practice location

Address: 5931 Stoney Creek Dr, Fort Wayne, IN 46825-4401
Phone: (260) 482-2206
Fax: (260) 483-3964

Authorised official

Name: Tonna B. Chalfant
Title: Manager
Phone: (260) 482-2206

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1104395680
Entity type: Organization
NPI issued: 14 Nov 2018
Record last updated: 14 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.