| Revive Wellness | |
|
119 Harry St First Floor Conshohocken PA 19428 | |
| (610) 457-8542 | |
| Not Available |
| Full Name | Revive Wellness |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 119 Harry St, Conshohocken, Pennsylvania |
| Authorized Official Name and Position | Leiza Stanley (OWNER) |
| Authorized Official Contact | 6404578542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Wellness 119 Harry Street Conshohocken PA 19428 Ph: () - | Revive Wellness 119 Harry St First Floor Conshohocken PA 19428 Ph: (610) 457-8542 |
| NPI Number | 1912443094 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 05/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912443094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CW016642 (Pennsylvania) | Primary |
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