Organization
REVITALIZE CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRETT KEITH SCHULTZ DC (CHIROPRACTOR/OWNER)
(701) 532-1672
Entity
Organization
Contact information
Practice address
4575 23RD AVE S STE 1100, FARGO, ND 58104-9052
(701) 532-1672
Mailing address
26748 130TH AVE N, ULEN, MN 56585-9629
(701) 212-3632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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