Organization
REVIVED MEDICAL SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARSHA KENNEDY NP (CO-OWNER)
(678) 559-2301
Entity
Organization
Contact information
Practice address
350 HILLGROVE DR, HOLLY SPRINGS, GA 30114-8601
(404) 551-6686
Mailing address
350 HILLGROVE DR, HOLLY SPRINGS, GA 30114-8601
(404) 551-6686
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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