| NPI | 1326712100 |
|---|---|
| Doing Business As | REVIVE SPA HYDRATION |
| Entity Type | Organization |
| Authorized Contact | BETH ANN SCHUBERT Owner 253-257-8340 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy |
| 163WN1003X Registered Nurse, Nutrition Support | |
| 261Q00000X | |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-06 |