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Organization
REVIVE MEDICAL SPA LLC
Active
Organization
REVIVE MEDICAL SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER BRETZ D.C. (PRACTICE OWNER & PROVIDER)
(941) 921-2225
Entity
Organization
Contact information
Practice address
2150 49TH ST N, ST PETERSBURG, FL 33710-5237
(727) 321-6130
Mailing address
5989 APPROACH RD, SARASOTA, FL 34238-5720
(941) 921-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AV987A
MEDICARE PTAN
FL
Enumeration date
01/05/2015
Last updated
01/05/2015
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