Provider Demographics
NPI:1922862846
Name:REJUVEN JOINT CARE
Entity Type:Organization
Organization Name:REJUVEN JOINT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PYSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-505-8321
Mailing Address - Street 1:242 ADLEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6511
Mailing Address - Country:US
Mailing Address - Phone:864-203-5715
Mailing Address - Fax:629-333-0251
Practice Address - Street 1:365 E BLACKSTOCK RD STE C
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3762
Practice Address - Country:US
Practice Address - Phone:864-203-5715
Practice Address - Fax:629-333-0251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REJUVEN JOINT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty