REVIVE FAMILY MEDICAL CLINIC, LLC

COLUMBUS, MS
NPI1902577554
Entity TypeOrganization
Authorized ContactMICAH ALEXANDER GRANT
Nurse Practitioner
662-570-4174
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
Enumeration Date2021-09-23
Last Update Date2021-11-18
Business Address
REVIVE FAMILY MEDICAL CLINIC, LLC
3549 BLUECUTT RD
COLUMBUS, MS 39705-1324
Phone number: 662-386-1541
Mailing Address
REVIVE FAMILY MEDICAL CLINIC, LLC
3549 BLUECUTT RD
COLUMBUS, MS 39705-1324
Phone number: 662-570-4174
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