OrganizationActive
I-Revive PLLC
NPI 1508473000 · Preventive Medicine/Occupational Environmental Medicine Physician · Grand Haven, MI
Provider details
- NPI number
- 1508473000
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Amanda Converse, Ceo/Founder
Practice location
525 Elliott Ave
Grand Haven, MI 49417-1038
Phone: (616) 566-1603
Fax: (616) 607-8588
Mailing address
525 Elliott Ave
Grand Haven, MI 49417-1038
Registry dates
- Enumerated
- 2020-09-28
- Last updated
- 2020-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.