Organization
REVIVE HEALTH CENTER AND SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLIE BAXTER D.C. (CHIROPRACTOR/OWNER)
(770) 345-1111
Entity
Organization
Contact information
Practice address
6875 HICKORY RD STE 110, WOODSTOCK, GA 30188-2011
(770) 345-1111
(770) 345-1788
Mailing address
6875 HICKORY RD STE 110, WOODSTOCK, GA 30188-2011
(770) 345-1111
(770) 345-1788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007723
GA
Other
Enumeration date
09/18/2007
Last updated
10/19/2016
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