Revive Nutrition LLC
NPI #1093345969 in Jamaica Plain, Massachusetts
Provider Information
- NPI Number
- 1093345969
- Entity Type
- Organization
- Organization Name
- Revive Nutrition LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Jan 20, 2020
- Last Updated
- Jul 10, 2024
Practice Location
- Address
- 3305 WASHINGTON ST UNIT 401
- City
- Jamaica Plain
- State
- Massachusetts
- ZIP Code
- 02130-5322
- Phone
- (314) 369-3159
Authorized Official
- Name
- KIMBERLY A SABADA, RD
- Title
- OWNER, REGISTERED DIETITIAN
- Phone
- (314) 369-3159
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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