| Revive Medical Llc | |
|
4215 N Classen Blvd Ste 103 Oklahoma City OK 73118 | |
| (951) 440-1652 | |
| Not Available |
| Full Name | Revive Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 4215 N Classen Blvd Ste 103, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Kevin Brown (OWNER) |
| Authorized Official Contact | 4056737856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Medical Llc 4215 N Classen Blvd Ste 103 Oklahoma City OK 73118-2431 Ph: (405) 673-7856 | Revive Medical Llc 4215 N Classen Blvd Ste 103 Oklahoma City OK 73118 Ph: (951) 440-1652 |
| NPI Number | 1528578499 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 08/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528578499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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