Organization
REVITALIFE TUBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILMHOFF (OWNER)
(859) 586-4500
Entity
Organization
Contact information
Practice address
6403 E BEND RD, BURLINGTON, KY 41005-9673
(859) 586-4500
Mailing address
PO BOX 746, BURLINGTON, KY 41005-0746
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
171WV0202X
Vehicle Modifications Contractor
—
—
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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