Organization
REVIVE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN SEYMOUR FNP-C (PRESIDENT)
(480) 299-7080
Entity
Organization
Contact information
Practice address
1205 E CARLA VISTA DR, GILBERT, AZ 85295-5408
(480) 299-7080
Mailing address
1242 N 104TH ST, MESA, AZ 85207-4504
(480) 299-7080
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
04/26/2023
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