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REVIVE SPINE AND PAIN CARE CENTER PC NPI 1346963667


NPI Information

NPI: 1346963667
Provider Name: REVIVE SPINE AND PAIN CARE CENTER, PC
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

Address:
11770 HAYNES BRIDGE RD UNIT 205-310
ALPHARETTA, GA
ZIP 30009
Phone: (616) 634-5365
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REVIVE SPINE AND PAIN CARE CENTER, PC is an interventional pain medicine pain medicine in Alpharetta, GA. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. REVIVE SPINE AND PAIN CARE CENTER, PC NPI is 1346963667. The provider is registered as an organization entity type.

The provider's business location address is:

11770 HAYNES BRIDGE RD UNIT 205-310
ALPHARETTA, GA
ZIP 30009-966
Phone: (616) 634-5365

The provider's authorized official is Jada J'nene Trashon Reese .
The authorized official title is Owner and has the following contact phone number (616) 634-5365.

The enumeration date for this NPI number is 9/21/2022 and was last updated on 10/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP3300XClinic/CenterPainNo
2208VP0014XPain MedicineInterventional Pain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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