| NPI | 1326351651 |
|---|---|
| Doing Business As | DEVENU MEDICAL REJUVENATION CENTER |
| Entity Type | Organization |
| Authorized Contact | JON FULCHER President 402-445-6173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IA 23224) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2010-07-15 |