| NPI | 1265915078 |
|---|---|
| Former Legal Business Name | RENEW SKIN AND BODY REJUVENATION LLC |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE L JONES Co Owner 575-736-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2020-10-23 |