REVIVED VITALITY

MYRTLE BEACH, SC
NPI1992588750
Entity TypeOrganization
Authorized ContactJENNINGS MICHAEL PERRY
Owner/Provider
843-855-2299
Organization Subpart ?No
Primary Taxonomy261Q00000X 
Enumeration Date2023-08-16
Last Update Date2023-08-16
Business Address
REVIVED VITALITY
1301 48TH AVE N # A-2
MYRTLE BEACH, SC 29577-5427
Phone number: 843-580-3694
Mailing Address
REVIVED VITALITY
606 BALD EAGLE DR STE 201
MARCO ISLAND, FL 34145-2731
Phone number: 843-855-2299
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