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Organization

REVIVE RX

Active
Other names
N/A
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KRYSTAL DUBLIN (CEO)
(770) 946-6976
Entity
Organization

Contact information

Practice address
1252 TODIWAY CT, JONESBORO, GA 30238-6546
(770) 946-6976
Mailing address
154 RAINBOW WAY UNIT 257, FAYETTEVILLE, GA 30214-3994
(770) 946-6976
(972) 777-5274

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
10/16/2023
Last updated
10/16/2023
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