Provider Demographics
NPI:1962917153
Name:REJUVEUNIQUE, INC
Entity type:Organization
Organization Name:REJUVEUNIQUE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOUHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-226-0910
Mailing Address - Street 1:40 BARKLEY CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4518
Mailing Address - Country:US
Mailing Address - Phone:239-226-0910
Mailing Address - Fax:239-226-0912
Practice Address - Street 1:4259 10TH AVE N STE B
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2323
Practice Address - Country:US
Practice Address - Phone:561-218-4951
Practice Address - Fax:561-218-4961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-10
Last Update Date:2017-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain