Organization
REVIVE WELLNESS & REJUVENATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE KNOX (PRACTICE ADMINISTRATOR)
(602) 595-7836
Entity
Organization
Contact information
Practice address
13934 N 59TH AVE, SUITE 100, GLENDALE, AZ 85306-4167
(602) 595-7836
(602) 419-2210
Mailing address
13934 N 59TH AVE, SUITE 100, GLENDALE, AZ 85306-4167
(602) 595-7836
(602) 419-2210
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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