| NPI | 1356048060 |
|---|---|
| Doing Business As | REVIVE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | JORDAN B COHEN President 760-963-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |