| Revivify Chiropractic Wellness Center | |
|
3528 Adirondack Way Ste 120 Wilmington NC 28403-0166 | |
| (910) 679-4079 | |
| Not Available |
| Full Name | Revivify Chiropractic Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3528 Adirondack Way Ste 120, Wilmington, North Carolina |
| Authorized Official Name and Position | Amanda Carolina Cruz-lamboy (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 7874229213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revivify Chiropractic Wellness Center 3528 Adirondack Way Ste 120 Wilmington NC 28403-0166 Ph: (910) 679-4079 | Revivify Chiropractic Wellness Center 3528 Adirondack Way Ste 120 Wilmington NC 28403-0166 Ph: (910) 679-4079 |
| NPI Number | 1992567424 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 03/04/2024 |
| Medicare PECOS PAC ID | 3678910981 |
|---|---|
| Medicare Enrollment ID | O20240322000311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992567424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Amanda Carolina Cruz-lamboy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265177364 PECOS PAC ID: 7214314624 Enrollment ID: I20220524000911 |
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