Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rejuvenation Medspa

Organization Family Medicine Physician · NPI 1780158287

Rejuvenation Medspa is a Family Medicine Physician in Bridgeport, West Virginia. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

1400 Johnson Ave Ste 4A
Bridgeport, WV 26330-1063
Phone: (304) 848-9998
Fax: (304) 848-9996
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1780158287
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Peasak — Owner/Provider · (304) 841-1293
NPI enumeratedJanuary 17, 2019
Last updated in NPPESJanuary 17, 2019
Mailing address1400 Johnson Ave Ste 4a, Bridgeport, WV 26330-1063

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