REVIVAL IV AND WELLNESS CLINIC LLC

SHELTON, CT
NPI1033974878
Entity TypeOrganization
Authorized ContactKEISHA ASANTE
Fnp
475-314-3011
Organization Subpart ?No
Primary Taxonomy261Q00000X 
Enumeration Date2024-02-20
Last Update Date2024-02-20
Business Address
REVIVAL IV AND WELLNESS CLINIC LLC
12 PROGRESS DR STE 1D
SHELTON, CT 06484-6290
Phone number: 475-314-3011
Mailing Address
REVIVAL IV AND WELLNESS CLINIC LLC
120 LONGVIEW DR
STRATFORD, CT 06614-1398
Phone number:
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