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Organization

REVIVE LOW T, LLC

Active
Parent organization
REVIVE LOW T, LLC
Other names
Revive Low T Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
REVIVE LOW T, LLC
Authorized official
BARRY WHEELER ND (MEMBER)
(425) 516-5500
Entity
Organization

Contact information

Practice address
720 S 320TH ST STE A, FEDERAL WAY, WA 98003-5254
(206) 960-4770
(866) 998-1837
Mailing address
11903 NE 128TH ST STE A, KIRKLAND, WA 98034-7209
(425) 820-3800
(866) 998-1837

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT60120417
WA

Other

Enumeration date
07/07/2017
Last updated
07/07/2017
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