| NPI | 1205443405 |
|---|---|
| Doing Business As | REVIVE LIFE TREATMENT CENTER OF SOUTH JERSEY |
| Entity Type | Organization |
| Authorized Contact | GREGORY PISTONE Owner 856-983-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207N00000X Dermatology |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |