Organization
REVAMP WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIS CHEPKORIR MUTEMBETE NP (OWNER)
(480) 747-4623
Entity
Organization
Contact information
Practice address
410 E SOUTHERN AVE, TEMPE, AZ 85282-5212
(480) 747-4623
Mailing address
410 E SOUTHERN AVE, TEMPE, AZ 85282-5212
(480) 747-4623
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
05/22/2023
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