NPI 1134408214

Renovus Medical Spa

Organisation Point of Service Gray, TN

Practice location

Address: 405 Roy Martin Rd STE 104, Gray, TN 37615-2551
Phone: (423) 207-0154

Authorised official

Name: Kathy Beard
Title: Owner
Phone: (423) 207-0154

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 17509 (TN)

Other Point of Service providers in Tennessee →

Registry record

NPI: 1134408214
Entity type: Organization
NPI issued: 8 Aug 2011
Record last updated: 8 Aug 2011

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.