Revitawound Incorporated
NPI #1538982533 in Burbank, California
Provider Information
- NPI Number
- 1538982533
- Entity Type
- Organization
- Organization Name
- Revitawound Incorporated
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Nov 7, 2024
- Last Updated
- Nov 19, 2024
Practice Location
- Address
- 146 N SAN FERNANDO BLVD STE 213
- City
- Burbank
- State
- California
- ZIP Code
- 91502-1230
- Phone
- (562) 506-6577
Authorized Official
- Name
- JENNIFER MATA
- Title
- OWNER
- Phone
- (562) 506-6577
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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