Individual
DR. CAROL REVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NMD
Contact information
Practice address
640 S TUDOR PL, TUCSON, AZ 85710-4256
(520) 749-9655
(520) 239-8515
Mailing address
640 S TUDOR PL, TUCSON, AZ 85710-4256
(520) 401-7595
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AZ 97-0516
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ 97-05516
BUSINESS LICENSE
AZ
Enumeration date
05/19/2008
Last updated
04/17/2023
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