Revitalize Integrated Body Systems

NPI 1124341813 - Chiropractor - 111N00000X

NPI Details
NPI 1124341813
Enumeration Date 03/09/2010
Last Updated 03/09/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ANGELIQUE ANGELIQUE
Position PRESIDENT
Phone (408) 295-9970
Fax
Practice Location
1618 EL CAMINO REAL
MENLO PARK CA, 94025-4112, US
Phone (408) 295-9970
Fax
Business Location
1618 EL CAMINO REAL
MENLO PARK CA, 94025-4112, US
Phone (408) 295-9970
Fax
Toxanomy
Taxonomy Code 111N00000X
License State California
License Number DC30496
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According to our database, Revitalize Integrated Body Systems NPI is 1124341813, taxonomy code is 111N00000X and license number is DC30496, license state is located at California. Revitalize Integrated Body Systems physically located at 1618 El Camino Real, Menlo Park CA, 94025-4112. NPI Number 1033115704 has the healthcare provider type.

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1124341813 NPI number is provided on an as is basis without warranty of any kind. 1124341813 is maintained by the National Plan & Provider Enumeration System. The contents of Revitalize Integrated Body Systems are for informational purposes only.