| Revival Health Medical Group Ks Pa | |
|
2703 W 146th Street Leawood KS 66224 | |
| (816) 714-9292 | |
| Not Available |
| Full Name | Revival Health Medical Group Ks Pa |
|---|---|
| Speciality | General Practice |
| Location | 2703 W 146th Street, Leawood, Kansas |
| Authorized Official Name and Position | Charles I. Carino (PRESIDENT) |
| Authorized Official Contact | 8167149292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Health Medical Group Ks Pa 2703 W 146th Street Leawood KS 66224 Ph: (816) 714-9292 | Revival Health Medical Group Ks Pa 2703 W 146th Street Leawood KS 66224 Ph: (816) 714-9292 |
| NPI Number | 1184381519 |
|---|---|
| Provider Enumeration Date | 11/19/2021 |
| Last Update Date | 11/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184381519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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