| NPI | 1801591284 |
|---|---|
| Doing Business As | REVIVE MEDICAL AESTHETICS AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JOANNE ELIZABETH MACKIN Np/Office Administrator 662-397-2795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |