| NPI | 1104504406 |
|---|---|
| Doing Business As | REVITALIFE WEIGHT LOSS CLINICS |
| Entity Type | Organization |
| Authorized Contact | DAVIA WARD CEO 770-744-1409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-07-06 |