Organization
REVIVAL HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW O'BLENESS DC (OWNER)
(319) 795-1253
Entity
Organization
Contact information
Practice address
2200 NW 152ND ST., STE. C, CLIVE, IA 50325
(319) 795-1253
Mailing address
1052 NW RICHMOND RD, WAUKEE, IA 50263-1017
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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