Revived Medical Spa LLC
NPI #1538837737 in Holly Springs, Georgia
Provider Information
- NPI Number
- 1538837737
- Entity Type
- Organization
- Organization Name
- Revived Medical Spa LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Sep 1, 2021
- Last Updated
- Sep 1, 2021
Practice Location
- Address
- 350 HILLGROVE DR
- City
- Holly Springs
- State
- Georgia
- ZIP Code
- 30114-8601
- Phone
- (404) 551-6686
Authorized Official
- Name
- TARSHA KENNEDY, NP
- Title
- CO-OWNER
- Phone
- (678) 559-2301
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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