Organization
REVIVAL SPINE SURGERY LLC
Active
Organization
REVIVAL SPINE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKASZ CURYLO MD (MD/PRESIDENT)
(314) 690-8383
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD STE 589A, SAINT LOUIS, MO 63141
(314) 690-8383
Mailing address
621 S NEW BALLAS RD STE 589A, SAINT LOUIS, MO 63141-8261
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
07/01/2018
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