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Organization
PD REVIVAL MEDICAL, PLLC
Active
Organization
PD REVIVAL MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNA POWERS (PMHNP)
(307) 272-0843
Entity
Organization
Contact information
Practice address
3130 SADDLE DR SUITE 6B, HELENA, MT 59601-8644
(307) 272-0843
Mailing address
3130 SADDLE DR, STUITE 6, HELENA, MT 59601-8644
(307) 272-0843
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/12/2022
Last updated
10/16/2024
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