| Revive Vitality | |
|
3425 Colonnade Pkwy Ste C Birmingham AL 35243-2356 | |
| (205) 588-6700 | |
| (205) 449-4959 |
| Full Name | Revive Vitality |
|---|---|
| Speciality | General Practice |
| Location | 3425 Colonnade Pkwy Ste C, Birmingham, Alabama |
| Authorized Official Name and Position | Ross Barnett (M.D./OWNER) |
| Authorized Official Contact | 2055886700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Vitality Po Box 242848 Montgomery AL 36124-2848 Ph: () - | Revive Vitality 3425 Colonnade Pkwy Ste C Birmingham AL 35243-2356 Ph: (205) 588-6700 |
| NPI Number | 1558898874 |
|---|---|
| Provider Enumeration Date | 05/17/2017 |
| Last Update Date | 05/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558898874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 17022747 (Alabama) | Primary |
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