| NPI | 1497436000 |
|---|---|
| Doing Business As | WOUND REJUVENATION |
| Entity Type | Organization |
| Authorized Contact | TIFFANY L LOPEZ CEO 724-984-7093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |