Organization
REVIVE BODYWORKS
Active
Other names
Revive Bodyworks Corp
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA KOLANO LMT (OWNER)
(631) 943-1243
Entity
Organization
Contact information
Practice address
523 TOWNLINE RD STE 7, HAUPPAUGE, NY 11788-2827
(631) 943-1243
Mailing address
316 DOLPHIN LN, WEST BABYLON, NY 11704-8504
(631) 943-1243
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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