Organization
REVIVE AESTHETICS & SPA WASILLA, LLC
Active
Other names
Revive
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN MORROW (OPERATIONS MANAGER)
(907) 373-7546
Entity
Organization
Contact information
Practice address
1175 N LEATHERLEAF LOOP STE F, WASILLA, AK 99654-6527
(907) 373-7546
(907) 373-7536
Mailing address
1175 N LEATHERLEAF LOOP STE F, WASILLA, AK 99654-6527
(907) 373-7546
(907) 373-7536
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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