Organization · Type 2 NPI

Revitalife Wellness Center LLC

Family Medicine Physician · St. Louis, MO

NPI number 1104185685 Active

Practice location

777 S New Ballas Rd, Ste 100E
St. Louis, MO 63141-8705

Call (314) 913-5861 Map

Mailing address

11402 Oxbridge Ct
St. Louis, MO 63146-5491

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XNone listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1104185685

Revitalife Wellness Center LLC's National Provider Identifier is 1104185685, issued on May 3, 2012. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in St. Louis, MO. The record was last updated on May 23, 2012.