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Contact Information

REVIVE ATHLETICS, INC
460 BOURNE DRIVE
SMYRNA, GA30082
 Phone: 770-899-8187
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for REVIVE ATHLETICS INC · (Female)

NPI # 1487964193
Status Active
Credentials
Entity Individual
Enumeration date 10/15/2010
Last updated 10/15/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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