Organization
REVIVED MOBILITY LLC
Active
Other names
Hybrid Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MCGILLEN (OWNER)
(630) 800-9226
Entity
Organization
Contact information
Practice address
2561 W SELTICE WAY, POST FALLS, ID 83854-8093
(208) 981-0132
Mailing address
2561 W SELTICE WAY, POST FALLS, ID 83854-8093
(208) 981-0132
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/28/2021
Last updated
03/07/2024
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