Organization
REVIVE ORTHOPEDICS AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BOBENKO (OFFICE MANAGER)
(973) 949-6553
Entity
Organization
Contact information
Practice address
571 LAFAYETTE AVE, HAWTHORNE, NJ 07506-2424
(973) 949-6553
Mailing address
571 LAFAYETTE AVE, HAWTHORNE, NJ 07506-2424
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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