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1518460047
REVIVE CLINIC LLC
OKLAHOMA CITY, OK
NPI
1518460047
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Entity Type
Organization
Authorized Contact
JEREMY CARTER
Partner
405-392-3300
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2018-03-12
Last Update Date
2018-03-12
Business Address
REVIVE CLINIC LLC
13316 S WESTERN AVE STE F
OKLAHOMA CITY, OK 73170-7309
Phone number: 405-703-8882
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Mailing Address
REVIVE CLINIC LLC
13316 S WESTERN AVE STE F
OKLAHOMA CITY, OK 73170-7309
Phone number: 405-703-8882
Copy
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