REVIV PLLC
General Practice Physician · FARGO, ND
Organization Active NPI 1114595824
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ✓ | — | — |
| Health Service Clinic/Center | 261QH0100X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.