| Revival Health Center, Llc | |
|
2200 Nw 152nd St., Ste. C, Clive, IA 50325 | |
| (319) 795-1253 | |
| Not Available |
| Full Name | Revival Health Center, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2200 Nw 152nd St., Clive, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821755562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Andrew John O'bleness |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1609411750 PECOS PAC ID: 6608202304 Enrollment ID: I20200128001730 |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Health Center, Llc 1052 Nw Richmond Rd, Waukee, IA 50263-1017 Ph: () - | Revival Health Center, Llc 2200 Nw 152nd St., Ste. C, Clive, IA 50325 Ph: (319) 795-1253 |
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