# REVLIS MEDICAL, 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:** 1386223196
- **Authorized official:** MICHAEL MCKEOWN DC (MANAGER)
- **Authorized official phone:** (845) 551-8166

## Contact information

- **Practice address:** 1040 EDGEWATER PKWY STE 104, SUITE 104, INDIAN LAND, SC 29707-4526
- **Practice address phone:** (845) 551-8166
- **Mailing address:** 1040 EDGEWATER PKWY, SUITE 104, INDIAN LAND, SC 29707-4526
- **Mailing address phone:** (845) 551-8166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2021
- **Last updated:** 04/22/2024