| NPI | 1104564962 |
|---|---|
| Other Name | REVAMP HEALTH MEDSPA |
| Entity Type | Organization |
| Authorized Contact | JEANNETTE PENA Owner 786-501-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-05-23 |