| NPI | 1205479888 |
|---|---|
| Doing Business As | REVIVE DERMATOLOGY CLINIC AND SPA |
| Entity Type | Organization |
| Authorized Contact | STEFANIE GATICA Owner 515-965-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2024-08-14 |