| NPI | 1952815466 |
|---|---|
| Doing Business As | REVIVIFY BIOLOGICS |
| Entity Type | Organization |
| Authorized Contact | ELLEN ROSE BECKER Nurse Practioner 817-886-4319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |