REVITA LIFE
Dietitian and Nutritionist at John R, Detroit, MI

License number
Michigan AN066667
Category
Dietitian and Nutritionist
Type
Dietary Manager
Owner
Name: DR. ANDRE R NUNN M.D.
Title: PRESIDENT
Phone: (313) 745-7454
Address
Address
4106 John R St SUITE 805, Detroit, MI 48201
National Provider ID: 1225139439
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about REVITA LIFE at bizstanding.com

REVITA LIFE, PC

Detroit, MI

Status:
Inactive
Registration:
Jul 28, 2006
Addresses:
4160 John R STE #805, Detroit, MI 48201 (Physical)
Michigan (Mailing)
State ID:
38255A
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2009
Agent:
Andre Nunn

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