Organization
REVIVIFY WOUND CARE AND SOFT TISSUE SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN GUTIERREZ (OWNER)
(702) 886-2269
Entity
Organization
Contact information
Practice address
4533 MERKEL BLUFF ST, LAS VEGAS, NV 89147-5128
(702) 886-2269
Mailing address
4533 MERKEL BLUFF ST, LAS VEGAS, NV 89147-5128
(702) 886-2269
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/20/2025
Last updated
07/10/2025
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