Organization · Type 2 NPI
Revival Wellness LLC
Adult Medicine Physician · Morris, MN
NPI number
1790653533
Active
Practice location
511 Oregon Ave Pdt Suite B3
Morris, MN 56267
Fax (320) 491-0594
Mailing address
511 Oregon Ave
Morris, MN 56267-3712
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | None listed |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1790653533
Revival Wellness LLC's National Provider Identifier is 1790653533, issued on Oct 24, 2025. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Morris, MN. The record was last updated on Oct 24, 2025.