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

Revive Pain Centers PA

Organization Family Medicine Physician · NPI 1760005771

Revive Pain Centers PA is a Family Medicine Physician in Minnetonka, Minnesota. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

14525 Highway 7 Ste 375
Minnetonka, MN 55345-3741
Phone: (651) 308-6190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1760005771
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Troy Stuckey — Authorized Official · (651) 308-6190
NPI enumeratedMay 26, 2020
Last updated in NPPESMay 26, 2020
Certification dateMay 26, 2020
Mailing address14525 Highway 7 Ste 375, Minnetonka, MN 55345-3741

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