Organization
REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEVIN D. POLLYDORE MD (CEO)
(770) 769-1724
Entity
Organization
Contact information
Practice address
939 BOB ARNOLD BLVD STE D, LITHIA SPRINGS, GA 30122-3258
(770) 769-1724
(770) 708-6599
Mailing address
939 BOB ARNOLD BLVD STE A, LITHIA SPRINGS, GA 30122-3258
(770) 769-1724
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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