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General NPI Number Information
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NPI Number | 1881175388
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Entity Type | Organization
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Legal Business Name | REVOLUTIONS NATUROPATHIC MEDICAL SOLUTIONS
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 230 BLUE RAVINE RD
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City | FOLSOM
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State | CA
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Zip | 95630-4748
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Country | US
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Telephone | 916-351-9355
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Fax | 916-351-5600
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Provider Business Mailing Address
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Address Line | 230 BLUE RAVINE RD
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City | FOLSOM
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State | CA
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Zip | 95630-4748
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Country | US
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Telephone | 916-351-9355
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Fax | 916-351-5600
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Authorized Official
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Title or Position | CEO/PRES
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Name | DR. MICHELE RAITHEL
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Credential | ND
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Telephone | 916-365-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-312
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License Number State | CA
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