| Revival Iv And Wellness Clinic Llc | |
|
12 Progress Dr Ste 1d Shelton CT 06484-6290 | |
| (475) 314-3011 | |
| (475) 314-3011 |
| Full Name | Revival Iv And Wellness Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 12 Progress Dr Ste 1d, Shelton, Connecticut |
| Authorized Official Name and Position | Keisha Asante (FNP) |
| Authorized Official Contact | 4753143011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Iv And Wellness Clinic Llc 120 Longview Dr Stratford CT 06614-1398 Ph: () - | Revival Iv And Wellness Clinic Llc 12 Progress Dr Ste 1d Shelton CT 06484-6290 Ph: (475) 314-3011 |
| NPI Number | 1033974878 |
|---|---|
| Provider Enumeration Date | 02/20/2024 |
| Last Update Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033974878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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