REVITALIZE HYDRATION THERAPY, LLC is a gerontology nurse practitioner in Flowood, MS. REVITALIZE HYDRATION THERAPY, LLC NPI is 1285261123. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
885 LIBERTY RD STE 300
FLOWOOD, MS
ZIP 39232-006
Phone: (601) 213-0069
The provider's authorized official is Jennye Mardis .
The authorized official title is Staff and has the following contact phone number (601) 213-0069.
The CLIA number assigned to this NPI record is 25D2172355 - practitioner other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/23/2020 and was last updated on 11/10/2020.