Revitalife Center, P.a.

NPI #1225306608 in Spring Lake Park, Minnesota

Provider Information

NPI Number
1225306608
Entity Type
Organization
Organization Name
Revitalife Center, P.a.
Primary Specialty
Chiropractor
Enumeration Date
Dec 13, 2011
Last Updated
Oct 25, 2012

Practice Location

Address
8097 HIGHWAY 65 NE STE 102
ZIP Code
55432-4511
Phone
(763) 710-4085

Authorized Official

Name
DR. LINDA PHAM, D.C.
Title
OWNER/CHIROPRACTOR
Phone
(763) 710-4085

Specialties & Taxonomy Codes

Specialty
Chiropractor

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