| NPI | 1548740749 |
|---|---|
| Doing Business As | REVIVIFY HEALTH |
| Entity Type | Organization |
| Authorized Contact | SHIRRANNA TODD President 479-301-8829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: ND 11106) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |