Organization
LONGEVITY WELLNESS GROUP, PLLC
Active
Other names
Revive Longevity
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON HANA DO (OWNER)
(248) 228-4598
Entity
Organization
Contact information
Practice address
7479 MIDDLEBELT RD STE 3, WEST BLOOMFIELD, MI 48322-4175
(248) 387-9414
Mailing address
7479 MIDDLEBELT RD STE 3, WEST BLOOMFIELD, MI 48322-4175
(248) 387-9414
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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