| NPI | 1962393306 |
|---|---|
| Doing Business As | REVIVE PAIN SOLUTIONS GRAND RAPIDS |
| Entity Type | Organization |
| Authorized Contact | DIANN M. BASCH Supervising Physician 616-822-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-14 |