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1184252678
REVIVE WELLNESS AND REJUVENATION LLC
GLENDALE, AZ
NPI
1184252678
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Entity Type
Organization
Authorized Contact
ROBERT GRAHAM
President
602-595-7836
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2020-03-30
Last Update Date
2020-05-01
Business Address
REVIVE WELLNESS AND REJUVENATION LLC
20229 N 67TH AVE STE C-A
GLENDALE, AZ 85308-6664
Phone number: 602-595-7836
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Mailing Address
REVIVE WELLNESS AND REJUVENATION LLC
20229 N 67TH AVE STE C-A
GLENDALE, AZ 85308-6664
Phone number: 602-595-7836
Copy
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