| NPI | 1811668593 |
|---|---|
| Other Name | PRIME REGEN DECATUR LLC |
| Entity Type | Organization |
| Authorized Contact | RANDALL LEE HAUPT Regional Practice Manager 470-292-3820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-12-07 |