Organization
REVIVE MEDSPA LLC
Active
Organization
REVIVE MEDSPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI TANASESCU (CFO)
(410) 812-5871
Entity
Organization
Contact information
Practice address
11350 MCCORMICK RD STE 800, HUNT VALLEY, MD 21031-1002
(410) 261-6199
Mailing address
11350 MCCORMICK RD STE 800, HUNT VALLEY, MD 21031-1002
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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