Organization
AURELIUS AESTHETICS LLC
Active
Other names
Revive Medical Aesthetics and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNE ELIZABETH MACKIN NP (NP/OFFICE ADMINISTRATOR)
(662) 397-2795
Entity
Organization
Contact information
Practice address
1805 STATION DR STE C, PRATTVILLE, AL 36066-5670
(334) 288-7808
Mailing address
448 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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