# REVIVE MEDICAL SPA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467175943
- **Authorized official:** DR. KAROLINA PRIEBE DNP (OWNER/PARTNER/NURSE PRACTITIONER)
- **Authorized official phone:** (907) 371-1766

## Contact information

- **Practice address:** 1905 COWLES ST STE B, FAIRBANKS, AK 99701-5914
- **Practice address phone:** (907) 371-1766
- **Practice address fax:** (907) 531-7365
- **Mailing address:** 1905 COWLES ST STE B, FAIRBANKS, AK 99701-5914
- **Mailing address phone:** (907) 371-1766
- **Mailing address fax:** (907) 531-7365

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/21/2022
- **Last updated:** 09/21/2022