| NPI | 1225306608 |
|---|---|
| Doing Business As | REVITALIFE CENTER |
| Entity Type | Organization |
| Authorized Contact | LINDA PHAM Owner/Chiropractor 763-710-4085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 5552) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2012-10-25 |