| NPI | 1346911195 |
|---|---|
| Other Name | REVKETA |
| Entity Type | Organization |
| Authorized Contact | JILL MICHELLE DUBRAVCIC Owner/Operator 928-213-6931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2021-09-22 |