# REVITALIFE WELLNESS CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1104185685
- **Authorized official:** DR. CHRISTINA ROBINS MD (PRESIDENT)
- **Authorized official phone:** (314) 913-5861

## Contact information

- **Practice address:** 777 S NEW BALLAS RD, STE 100E, SAINT LOUIS, MO 63141-8705
- **Practice address phone:** (314) 913-5861
- **Mailing address:** 11402 OXBRIDGE CT, SAINT LOUIS, MO 63146-5491
- **Mailing address phone:** (314) 913-5861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2012
- **Last updated:** 05/23/2012