Organization
REVELATION ENTERPRISES INC
Active
Other names
Revelation Prosthetics, Inc., Rev Pro Inc Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANITA C MULLIN CMF (VICE PRESIDENT)
(405) 319-0685
Entity
Organization
Contact information
Practice address
4521 NW 3RD ST, OKLAHOMA CITY, OK 73127-6401
(405) 319-0685
(405) 319-0684
Mailing address
4521 NW 3RD ST, OKLAHOMA CITY, OK 73127-6401
(405) 319-0685
(405) 319-0684
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
39
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100812360A
—
OK
Enumeration date
10/27/2006
Last updated
01/24/2023
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