# REVIVE WELLNESS CLINIC OF STARKVILLE, LLC

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

## Provider details

- **NPI number:** 1558275008
- **Authorized official:** SARAH CLARK (MANAGER)
- **Authorized official phone:** (662) 801-5795

## Contact information

- **Practice address:** 100 RUSSELL ST STE 19, STARKVILLE, MS 39759-3398
- **Practice address phone:** (662) 801-5795
- **Mailing address:** 100 RUSSELL ST STE 19, STARKVILLE, MS 39759-3398
- **Mailing address phone:** (662) 801-5795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2026
- **Last updated:** 10/01/2026