Revival Pain Management, Inc

NPI 1164729257 - Pain Medicine - 208VP0014X

NPI Details
NPI 1164729257
Enumeration Date 02/25/2011
Last Updated 02/25/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name EMIDIO EMIDIO
Position OWNER
Phone (336) 835-5337
Fax
Practice Location
110 DUTCHMAN CT
ELKIN NC, 28621-2237, US
Phone (336) 835-5337
Fax
Business Location
PO BOX 100
JACKSON NJ, 08527-0100, US
Phone (732) 928-5346
Fax
Toxanomy
Taxonomy Code 208VP0014X
License State North Carolina
License Number 200201393
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According to our database, Revival Pain Management, Inc NPI is 1164729257, taxonomy code is 208VP0014X and license number is 200201393, license state is located at North Carolina. Revival Pain Management, Inc physically located at 110 Dutchman Ct, Elkin NC, 28621-2237. NPI Number 1033115704 has the healthcare provider type.

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1164729257 NPI number is provided on an as is basis without warranty of any kind. 1164729257 is maintained by the National Plan & Provider Enumeration System. The contents of Revival Pain Management, Inc are for informational purposes only.