OrganizationActive
Revival Wellness LLC
NPI 1790653533 · Adult Medicine Physician · Morris, MN
Provider details
- NPI number
- 1790653533
- Entity type
- Organization
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nathan Malek, Ceo(320) 491-0594
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
511 Oregon Ave Pdt Suite B3
Morris, MN 56267
Phone: (320) 491-0594
Fax: (320) 491-0594
Approximate (ZIP-level) locationGet directions
Mailing address
511 Oregon Ave
Morris, MN 56267-3712
Registry dates
- Enumerated
- 2025-10-24
- Last updated
- 2025-10-24
- Certified
- 2025-10-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.