Organization
REVIVE CHIROPRACTIC AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON MULLENS (OWNER LLC)
(814) 335-0454
Entity
Organization
Contact information
Practice address
12875 ROUTE 30 STE 25, NORTH HUNTINGDON, PA 15642-2595
(724) 382-5576
Mailing address
12875 ROUTE 30 STE 25, NORTH HUNTINGDON, PA 15642-2595
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC010524
PA
Other
Enumeration date
03/27/2013
Last updated
02/26/2014
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