Organization
REVITALIZE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA SIEVE PA (BUSINESS OWNER)
(515) 822-6384
Entity
Organization
Contact information
Practice address
1031 OFFICE PARK RD STE 2, WEST DES MOINES, IA 50265-2582
(515) 822-6384
(800) 507-4921
Mailing address
1031 OFFICE PARK RD STE 2, WEST DES MOINES, IA 50265-2582
(515) 822-6384
(800) 507-4921
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
04/29/2026
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