| NPI | 1417835018 |
|---|---|
| Doing Business As | REVIVAL PATH LLC |
| Entity Type | Organization |
| Authorized Contact | ERIN RISAVI TONGUE Owner, Nurse Practitioner 607-341-6559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |