Individual
MS. JOHANNAH RUTH REVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNIM, R. EPT.
Contact information
Practice address
25 HIGHLAND PARK VLG, SUITE 100-225, DALLAS, TX 75205-2789
(214) 536-1647
(972) 625-2884
Mailing address
25 HIGHLAND PARK VLG, SUITE 100-225, DALLAS, TX 75205-2789
(214) 536-1647
(972) 625-2884
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/08/2013
Last updated
09/24/2015
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