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1104185685
REVITALIFE WELLNESS CENTER LLC
SAINT LOUIS, MO
NPI
1104185685
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Entity Type
Organization
Authorized Contact
CHRISTINA ROBINS
President
314-913-5861
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2012-05-03
Last Update Date
2012-05-23
Business Address
REVITALIFE WELLNESS CENTER LLC
777 S NEW BALLAS RD STE 100E
SAINT LOUIS, MO 63141-8705
Phone number: 314-913-5861
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Mailing Address
REVITALIFE WELLNESS CENTER LLC
11402 OXBRIDGE CT
SAINT LOUIS, MO 63146-5491
Phone number: 314-913-5861
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