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Organization

REVITALIZED WELLNESS PLLC

Active
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Organization

REVITALIZED WELLNESS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTI LYNN ROSS (OWNER)
(605) 423-7557
Entity
Organization

Contact information

Practice address
326 E 8TH ST APT 206, SIOUX FALLS, SD 57103-7038
(605) 423-7557
(605) 305-1175
Mailing address
401 E 8TH ST STE 214-7054, SIOUX FALLS, SD 57103-7011
(605) 423-7557
(605) 305-1175

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
261QP2300X
Primary Care Clinic/Center
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
08/11/2020
Last updated
08/06/2026
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