Provider Demographics
NPI:1356828016
Name:RENO REGENERATIVE MEDICINE
Entity Type:Organization
Organization Name:RENO REGENERATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-683-9026
Mailing Address - Street 1:9437 DOUBLE DIAMOND PKWY STE 18
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8968
Mailing Address - Country:US
Mailing Address - Phone:775-683-9026
Mailing Address - Fax:775-683-9017
Practice Address - Street 1:9437 DOUBLE DIAMOND PKWY STE 18
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8968
Practice Address - Country:US
Practice Address - Phone:775-683-9026
Practice Address - Fax:775-683-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty