| Revive Health And Wellness, Llc | |
|
2112 Bienville Blvd Ste M1 Ocean Springs MS 39564-3027 | |
| (228) 324-5347 | |
| Not Available |
| Full Name | Revive Health And Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2112 Bienville Blvd Ste M1, Ocean Springs, Mississippi |
| Authorized Official Name and Position | Traci J White (OWNER) |
| Authorized Official Contact | 2283245347 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Health And Wellness, Llc 17804 Riverwalk Drive Vancleave MS 39565 Ph: (228) 324-5347 | Revive Health And Wellness, Llc 2112 Bienville Blvd Ste M1 Ocean Springs MS 39564-3027 Ph: (228) 324-5347 |
| NPI Number | 1255068425 |
|---|---|
| Provider Enumeration Date | 08/06/2022 |
| Last Update Date | 08/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255068425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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