| Revive Wound Care Ga Llc | |
|
980 Rowland St Ste 5140 #1111 Clarkston GA 30021 | |
| (951) 760-6216 | |
| Not Available |
| Full Name | Revive Wound Care Ga Llc |
|---|---|
| Speciality | General Practice |
| Location | 980 Rowland St, Clarkston, Georgia |
| Authorized Official Name and Position | Paul Davis (MANAGER) |
| Authorized Official Contact | 9517606216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Wound Care Ga Llc 980 Rowland St Ste 5140 #1111 Clarkston GA 30021 Ph: (951) 760-6216 | Revive Wound Care Ga Llc 980 Rowland St Ste 5140 #1111 Clarkston GA 30021 Ph: (951) 760-6216 |
| NPI Number | 1548082274 |
|---|---|
| Provider Enumeration Date | 10/24/2024 |
| Last Update Date | 10/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548082274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 251E00000X | Home Health | (* (Not Available)) | Secondary |
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