Organization
RHW VENTURES INC
Active
Other names
Revivify Health
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRRANNA TODD BA (PRESIDENT)
(479) 301-8829
Entity
Organization
Contact information
Practice address
615 W OAK ST, ROGERS, AR 72756-5315
(479) 879-3019
(479) 372-6609
Mailing address
615 W OAK ST, ROGERS, AR 72756-5315
(479) 879-3019
(479) 372-6609
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
11106
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265413629
—
ND
Enumeration date
08/16/2018
Last updated
08/16/2018
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