REVIVE WELLNESS AND REJUVENATION LLC

GLENDALE, AZ
NPI1184252678
Entity TypeOrganization
Authorized ContactROBERT GRAHAM
President
602-595-7836
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
Enumeration Date2020-03-30
Last Update Date2020-05-01
Business Address
REVIVE WELLNESS AND REJUVENATION LLC
20229 N 67TH AVE STE C-A
GLENDALE, AZ 85308-6664
Phone number: 602-595-7836
Mailing 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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