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Organization
REVELATION MEDICAL LLC
Active
Organization
REVELATION MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LINN (AUTHORIZED OFFICIAL)
(918) 398-8900
Entity
Organization
Contact information
Practice address
4636 S HARVARD AVE STE 104, TULSA, OK 74135-2908
(918) 398-8900
Mailing address
4636 S HARVARD AVE STE 104, TULSA, OK 74135-2908
(918) 398-8900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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