Organization
REVIVE SPINE AND PAIN CARE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADA J'NENE TRASHON REESE MD (OWNER)
(616) 634-5365
Entity
Organization
Contact information
Practice address
11770 HAYNES BRIDGE RD UNIT 205-310, ALPHARETTA, GA 30009-1966
(616) 634-5365
Mailing address
270 BEACON KNOLL DR, ALPHARETTA, GA 30022-6441
(616) 634-5365
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
09/21/2022
Last updated
10/13/2022
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