Organization
REVIVAL HEALTH MEDICAL GROUP OR P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES I. CARINO D.O. (PRESIDENT)
(816) 714-9292
Entity
Organization
Contact information
Practice address
2703 W 146TH ST, LEAWOOD, KS 66224-5921
(816) 714-9292
Mailing address
2703 W 146TH ST, LEAWOOD, KS 66224-5921
(816) 714-9292
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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