Organization
REVOLUTIONARY SERVICES LLC
Active
Other names
Stout Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN EARL STOUT D.C. F.N.P.-C (MANAGER)
(928) 768-2811
Entity
Organization
Contact information
Practice address
5130 HWY 95, FORT MOHAVE, AZ 86426-9374
(928) 768-2811
(928) 768-9787
Mailing address
5130 HWY 95, FORT MOHAVE, AZ 86426-9374
(928) 768-2811
(928) 768-9787
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
7353
AZ
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
03/01/2024
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