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Organization
FUNCTIONAL HEALTH REVOLUTION
Active
Organization
FUNCTIONAL HEALTH REVOLUTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM SEIDL (MEMBER)
(703) 214-5121
Entity
Organization
Contact information
Practice address
4445 CORPORATION LN STE 264, VIRGINIA BEACH, VA 23462-3671
(703) 214-5121
Mailing address
3301 RICHMOND HWY # 1127, ALEXANDRIA, VA 22305-3044
(703) 214-5121
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
NULL
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
11/22/2024
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