Revitalize Spine & Sports Care Pllc

LBN: Revitalize Spine & Sports Care Pllc
Revitalize Spine & Sports Care Pllc is an health care organization with primary practice located at 4309 W 27Th Pl Ste 202 , Kennewick WA 99338-2908. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty. Revitalize Spine & Sports Care Pllc can be contacted via phone (509) 591-4966, or through Groner, John via phone (509) 591-4966.

Contact Information

Primary practice address
4309 W 27Th Pl Ste 202 Kennewick WA 99338-2908
Phone: (509) 591-4966
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Groner, John Doctor of Medicine (MD)
Phone: (509) 591-4966

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X

Profile Details

NPI number 1407430317
LBN Legal business name Revitalize Spine & Sports Care Pllc
DBA Doing business as
Authorized official Groner, John Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 6th, 2021
Last updated May 6th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407430317 NPPES
Washington Other MD00049437 WA LICENSE

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