Revived Vitality
NPI #1992588750 in Myrtle Beach, South Carolina
Provider Information
- NPI Number
- 1992588750
- Entity Type
- Organization
- Organization Name
- Revived Vitality
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Aug 16, 2023
- Last Updated
- Aug 16, 2023
Practice Location
- Address
- 1301 48TH AVE N # A-2
- City
- Myrtle Beach
- State
- South Carolina
- ZIP Code
- 29577-5427
- Phone
- (843) 580-3694
Authorized Official
- Name
- DR. JENNINGS MICHAEL PERRY, DNP
- Title
- OWNER/PROVIDER
- Phone
- (843) 855-2299
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
Additional Practice Locations
606 Bald Eagle Dr Ste 201
Marco Island, FL, 34145-2731
(843) 855-2299
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