Organization
REVITALIZE HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY BIA (PART OWNER)
(918) 633-0622
Entity
Organization
Contact information
Practice address
16339 SILVER SPRING DR, CHOCTAW, OK 73020-5807
(918) 633-0622
Mailing address
16339 SILVER SPRING DR, CHOCTAW, OK 73020-5807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629739891
—
OK
05
—
17770075764
—
OK
Enumeration date
04/07/2025
Last updated
09/05/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us