# REVITALIZE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033090303
- **Authorized official:** AMANDA SIEVE PA (BUSINESS OWNER)
- **Authorized official phone:** (515) 822-6384

## Contact information

- **Practice address:** 1031 OFFICE PARK RD STE 2, WEST DES MOINES, IA 50265-2582
- **Practice address phone:** (515) 822-6384
- **Practice address fax:** (800) 507-4921
- **Mailing address:** 1031 OFFICE PARK RD STE 2, WEST DES MOINES, IA 50265-2582
- **Mailing address phone:** (515) 822-6384
- **Mailing address fax:** (800) 507-4921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2025
- **Last updated:** 04/29/2026