Organization
REVIVE THERAPEUTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYRA AZELIA MCMILLAN (LICENSED MASSAGE THERAPIST)
(813) 885-6029
Entity
Organization
Contact information
Practice address
18216 PRESTON RD STE B-3, DALLAS, TX 75252-5412
(813) 856-6029
Mailing address
6901 HANSELL RD APT 6313, PLANO, TX 75024-4217
(813) 856-6029
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/04/2025
Last updated
10/04/2025
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