| NPI | 1831946656 |
|---|---|
| Doing Business As | REVITALIZE AND OPTIMIZE CLINIC |
| Entity Type | Organization |
| Authorized Contact | PHILLIP CASEY DUBRAVCIC Owner/Operator/CEO 928-248-8082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-04-30 |