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REVITALIFE CENTER
NPI 1225306608
Chiropractor in Spring Lake Park, MN

Active since December 13, 2011
8097 HIGHWAY 65 NE STE 102, SPRING LAKE PARK, MN 55432(763) 710-4085 Get Directions Write a Review

NPPES record last updated: October 25, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revitalife Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVITALIFE CENTER (NPI 1225306608) is a healthcare organization registered as a chiropractor in Spring Lake Park, Minnesota and active in the NPI registry since December 2011. The organization lists Linda Pham, Owner/chiropractor, as its authorized official.

NPPES Registry Identity

NPI1225306608
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameREVITALIFE CENTER, P.A.
Location Address8097 HIGHWAY 65 NE STE 102Spring Lake Park, MN 55432-4511
Mailing Address8097 Highway 65 Ne Ste 102Spring Lake Park, MN 55432-4511 · (763) 710-4085
Phone(763) 710-4085
Organization SubpartNo
Authorized OfficialLinda PhamOwner/chiropractor · (763) 710-4085
Enumeration DateDecember 13, 2011
Last NPPES UpdateOctober 25, 2012
✔ NPI 1225306608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MN · 5552
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
8097 HIGHWAY 65 NE STE 102, Spring Lake Park, MN 55432
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Other Names 1

Doing Business AsRevitalife Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA PHAM D.C.
Chiropractor
8097 HIGHWAY 65 NE STE 102
SPRING LAKE PARK, MN 55432
Anoka County (763) 710-4085

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revitalife Center, P.A.'s NPI number?

The NPI number for Revitalife Center, P.A. is 1225306608. It was assigned to this organization in the NPPES registry on December 13, 2011. The provider is doing business as Revitalife Center.

Where is Revitalife Center, P.A. located?

Revitalife Center, P.A. is located at 8097 Highway 65 NE Ste 102, Spring Lake Park, MN 55432. The listed phone number is (763) 710-4085.

What is Revitalife Center, P.A.'s specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Revitalife Center, P.A. was last updated on October 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.