Organization
REVIVED WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BARKER ADMINISTRATION (MANAGER)
(801) 499-2373
Entity
Organization
Contact information
Practice address
776 E 800 S, CENTERVILLE, UT 84014-2512
(801) 424-9922
Mailing address
776 E 800 S, CENTERVILLE, UT 84014-2512
(801) 424-9922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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