| Revival Health And Wellness Clinic, Pllc | |
|
1602 Woods Ln Centralia IL 62801-6774 | |
| (706) 889-8349 | |
| Not Available |
| Full Name | Revival Health And Wellness Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1602 Woods Ln, Centralia, Illinois |
| Authorized Official Name and Position | Crea Rose (OWNER/ PROVIDER) |
| Authorized Official Contact | 7068898349 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Health And Wellness Clinic, Pllc 1602 Woods Ln Centralia IL 62801-6774 Ph: () - | Revival Health And Wellness Clinic, Pllc 1602 Woods Ln Centralia IL 62801-6774 Ph: (706) 889-8349 |
| NPI Number | 1366241507 |
|---|---|
| Provider Enumeration Date | 03/11/2025 |
| Last Update Date | 03/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366241507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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