Organization
REVITALIFE WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINA ROBINS MD (PRESIDENT)
(314) 913-5861
Entity
Organization
Contact information
Practice address
777 S NEW BALLAS RD, STE 100E, SAINT LOUIS, MO 63141-8705
(314) 913-5861
Mailing address
11402 OXBRIDGE CT, SAINT LOUIS, MO 63146-5491
(314) 913-5861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/03/2012
Last updated
05/23/2012
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