Organization
REVITALIZE MEDICAL SUPPLY
Active
Other names
Healix Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY WHITWORTH (OWNER)
(208) 589-0821
Entity
Organization
Contact information
Practice address
1680 ELK CREEK DR # 2, IDAHO FALLS, ID 83404-1225
(208) 757-4325
Mailing address
4954 E POWERHOUSE DR, IDAHO FALLS, ID 83406-5064
(208) 589-0821
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
01/17/2025
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