# MEN'S REVIVAL LLC

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

## Provider details

- **NPI number:** 1245003730
- **Authorized official:** MEGAN JORE RN (CO-OWNER)
- **Authorized official phone:** (757) 754-0938

## Contact information

- **Practice address:** 8752 E VIA DE COMMERCIO STE 2, SCOTTSDALE, AZ 85258-3396
- **Practice address phone:** (602) 935-4655
- **Practice address fax:** (833) 469-2578
- **Mailing address:** 8752 E VIA DE COMMERCIO STE 2, SCOTTSDALE, AZ 85258-3396
- **Mailing address phone:** (602) 935-4655
- **Mailing address fax:** (833) 469-2578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 175F00000X | Naturopath | — | NULL | Yes |
| 175F00000X | Naturopath | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2023
- **Last updated:** 11/07/2023