Organization
REVIVAL BODYWORKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD LOPEZ (CEO)
(818) 699-8998
Entity
Organization
Contact information
Practice address
5835 COLFAX AVE APT 2, NORTH HOLLYWOOD, CA 91601-1039
(818) 699-8998
Mailing address
5835 COLFAX AVE APT 2, NORTH HOLLYWOOD, CA 91601-1039
(818) 699-8998
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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