PD REVIVAL MEDICAL, PLLC

Mental Health Clinic/Center (Including Community Mental Health Center)

NPI: 1124764030Organization

Specialties, Licenses & Credentials

Code: 106H00000X

Clinic/Center — Mental Health (Including Community Mental Health Center)

Code: 261QM0801X

Physician Assistant — Medical

Code: 363AM0700X

Nurse Practitioner — Psychiatric/Mental Health

Code: 363LP0808X

Nurse Anesthetist, Certified Registered

Code: 367500000X

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