Revival Health and Wellness Clinic

NPI #1366241507 in Salem, Illinois

Provider Information

NPI Number: 1366241507
Entity Type: Organization
Organization Name: Revival Health and Wellness Clinic
Primary Specialty: Family Medicine
Enumeration Date: Mar 11, 2025
Last Updated: Jun 27, 2025

Practice Location

Address: 207 E MAIN ST
City: Salem
State: Illinois
ZIP Code: 62881-2926
Phone: (706) 889-8349

Authorized Official

Name: CREA ROSE, NP
Title: OWNER/ PROVIDER
Phone: (706) 889-8349

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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