Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revitalife Wellness Center LLC

Organization Family Medicine Physician · NPI 1104185685

Revitalife Wellness Center LLC is a Family Medicine Physician in Saint Louis, Missouri. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

777 S New Ballas Rd Ste 100E
Saint Louis, MO 63141-8705
Phone: (314) 913-5861
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1104185685
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christina Robins — President · (314) 913-5861
NPI enumeratedMay 3, 2012
Last updated in NPPESMay 23, 2012
Mailing address11402 Oxbridge Ct, Saint Louis, MO 63146-5491

Other providers in Saint Louis