Organization
IV LEAGUE HYDRATION THERAPY LLC
Active
Other names
revIVe Hydration Therapy & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIDNEY BRADLEY (CEO)
(813) 769-9127
Entity
Organization
Contact information
Practice address
2122 S DALE MABRY HWY, TAMPA, FL 33629-6312
(813) 769-9127
Mailing address
3709 W JETTON AVE STE A1, TAMPA, FL 33629-5115
(813) 769-9127
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
07/05/2022
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