Organization
DIVINITY HYDRATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY BROWN RN (CEO)
(877) 348-8333
Entity
Organization
Contact information
Practice address
313 BAINBRIDGE ST FL 1, PHILADELPHIA, PA 19147-1542
(877) 348-8333
Mailing address
313 BAINBRIDGE ST FL 1, PHILADELPHIA, PA 19147-1542
(877) 348-8333
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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