Provider Demographics
NPI:1689553026
Name:REJUVENATION CHIROPRACTIC & SPORTS REHAB PLLC
Entity type:Organization
Organization Name:REJUVENATION CHIROPRACTIC & SPORTS REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWSTER PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-324-7445
Mailing Address - Street 1:916 S 17TH ST # 13
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-8022
Mailing Address - Country:US
Mailing Address - Phone:910-685-4881
Mailing Address - Fax:
Practice Address - Street 1:916 S 17TH ST # 13
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-8022
Practice Address - Country:US
Practice Address - Phone:910-685-4881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service