NPI | 1225913916 |
---|---|
Doing Business As | REVITALIZED LIFESTYLE MEDICINE CONSULTING |
Entity Type | Organization |
Authorized Contact | KALYN JOLIVETTE Owner And Physician 740-202-0995 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Enumeration Date | 2025-08-11 |
Last Update Date | 2025-08-11 |