Provider Demographics
NPI:1346848975
Name:REGENERATIVE MEDICINE OF RICHMOND LLC
Entity Type:Organization
Organization Name:REGENERATIVE MEDICINE OF RICHMOND LLC
Other - Org Name:CHRONIC CARE OF RICHMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:DEANE
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-740-7105
Mailing Address - Street 1:8639 MAYLAND DR STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4752
Mailing Address - Country:US
Mailing Address - Phone:804-740-7105
Mailing Address - Fax:
Practice Address - Street 1:8639 MAYLAND DR STE 105
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4752
Practice Address - Country:US
Practice Address - Phone:804-740-7105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty