REVITAL AHL

ENCINO, CA
NPI1538769062
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  58759)
Enumeration Date2020-10-26
Last Update Date2020-10-26
Business Address
REVITAL AHL
18141 MEDLEY DR
ENCINO, CA 91316-4447
Phone number: 818-422-4077
Mailing Address
REVITAL AHL
18141 MEDLEY DR
ENCINO, CA 91316-4447
Phone number: