Revital LLC

NPI #1518320589 in Festus, Missouri

Provider Information

NPI Number: 1518320589
Entity Type: Organization
Organization Name: Revital LLC
Primary Specialty: Internal Medicine
Enumeration Date: Mar 29, 2016
Last Updated: Mar 29, 2016

Practice Location

Address: 101 MAIN ST
Address 2: SUITE 2300 B
City: Festus
State: Missouri
ZIP Code: 63028-1977
Phone: (314) 254-2420

Authorized Official

Name: KEVIN MEURET
Title: OWNER/CEO
Phone: (314) 254-2420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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