Organization · Type 2 NPI

I-Revive PLLC

Preventive Medicine/Occupational Environmental Medicine Physician · Grand Haven, MI

NPI number 1508473000 Active

Practice location

525 Elliott Ave
Grand Haven, MI 49417-1038

Fax (616) 607-8588

Specialties and licenses

Taxonomy	Code	License
Preventive Medicine/Occupational Environmental Medicine Physician Primary	2083P0500X	None listed
Home Health Agency	251E00000X	None listed

Preventive Medicine/Occupational Environmental Medicine Physician: A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

Another provider at this address

Amanda M. Converse I, LMTMassage Therapist Grand Haven, MI NPI 1205435161

NPI record

NPI: 1508473000
Entity type: Organization (Type 2)
Issued: Sep 28, 2020
Last updated: Nov 5, 2020
Status: Active

Other names

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My Medical Massage · doing business as
My Medical Massage · doing business as

Authorized official

Ms. Amanda M Converse, LMT, CIMT, CPMT
CEO/founder
(616) 377-8893

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508473000

I-Revive PLLC's National Provider Identifier is 1508473000, issued on Sep 28, 2020. The primary taxonomy on file is Preventive Medicine/Occupational Environmental Medicine Physician (2083P0500X), and the practice location is in Grand Haven, MI. The record was last updated on Nov 5, 2020.