Organization
REVITALIZE CHIROPRACTIC AND SPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRINA CLARK DC, MS (DOCTOR/OWNER)
(256) 343-4493
Entity
Organization
Contact information
Practice address
27453 CAPSHAW RD STE E, ATHENS, AL 35613-7565
(256) 343-4493
Mailing address
14814 IMPERIAL DR, ATHENS, AL 35613-7456
(256) 343-4493
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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