Organization · Type 2 NPI

Revelation Enterprises Inc

Prosthetic/Orthotic Supplier · Oklahoma City, OK

NPI number 1740366210 Active

Practice location

4521 NW 3rd St
Oklahoma City, OK 73127-6401

Fax (405) 319-0684

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	39 (OK)

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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NPI record

NPI: 1740366210
Entity type: Organization (Type 2)
Issued: Oct 27, 2006
Last updated: Jan 24, 2023
Status: Active

Other names

<unavail>
Rev Pro Inc Prosthetics & Orthotics · doing business as
Revelation Prosthetics, Inc. · doing business as

Authorized official

Mrs. Anita C Mullin, CMF
Vice President
(405) 319-0685

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About NPI 1740366210

Revelation Enterprises Inc's National Provider Identifier is 1740366210, issued on Oct 27, 2006. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Oklahoma City, OK. The record was last updated on Jan 24, 2023.