Organization
REVIVAL SKIN ARTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY D KESNER (OWNER)
(720) 483-2006
Entity
Organization
Contact information
Practice address
10080 W 26TH AVE, LAKEWOOD, CO 80215-1429
(720) 483-2006
Mailing address
10080 W 26TH AVE, LAKEWOOD, CO 80215-1429
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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