Organization
REVIVE SPINE AND PAIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE NAMMOUR (MANAGER)
(856) 983-9001
Entity
Organization
Contact information
Practice address
1001 LINCOLN DR W STE E, MARLTON, NJ 08053-1534
(856) 983-9001
(856) 983-9011
Mailing address
PO BOX 1126, ABSECON, NJ 08201-5126
(856) 983-9001
(856) 983-9011
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
01/04/2017
Last updated
01/31/2024
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