REVIVE SALON AND SPA

SAN DIEGO, CA
NPI1619415072
Entity TypeOrganization
Authorized ContactMARY LYNN ELIZABETH EICHERT
Nurse Practitioner
704-516-6782
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  95005931)
Enumeration Date2017-02-06
Last Update Date2017-02-06
Business Address
REVIVE SALON AND SPA
5965 VILLAGE WAY E207
SAN DIEGO, CA 92130-2475
Phone number: 619-293-7233
Mailing Address
REVIVE SALON AND SPA
4328 MOUNT HUKEE AVE
SAN DIEGO, CA 92117-4738
Phone number: 704-516-6782