Revitalize Alabama L.l.c

NPI #1942975180 in Auburn, Alabama

Provider Information

NPI Number: 1942975180
Entity Type: Organization
Organization Name: Revitalize Alabama L.l.c
Primary Specialty: Family Medicine
Enumeration Date: Aug 10, 2021
Last Updated: Oct 6, 2021

Practice Location

Address: 105 1ST STREET
City: Auburn
State: Alabama
ZIP Code: 36830-0000
Phone: (334) 734-7973

Authorized Official

Name: MR. TRAVIS WOODLEY, CRNP
Title: PRESIDENT
Phone: (334) 734-7973

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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