Kaniel Revis

NPI #1134574486 in Freeland, Michigan

Provider Information

NPI Number: 1134574486
Entity Type: Individual
Name: Kaniel Revis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Apr 24, 2016
Last Updated: Apr 24, 2016

Practice Location

Address: 8755 CARTER RD APT 34
City: Freeland
State: Michigan
ZIP Code: 48623-8768
Phone: (989) 213-2903

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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