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Dr. Revivajennz Med Spa, Pllc
Clinic/Center in Ann Arbor, Michigan
NPI 1083310312

Dr. Revivajennz Med Spa, Pllc is a Clinic/Center based in Ann Arbor, MI. Dr. Revivajennz Med Spa, Pllc practices in Ann Arbor, MI. The NPI Number for Dr. Revivajennz Med Spa, Pllc is 1083310312 and holds a License No. (Michigan).

The current practice location address for Dr. Revivajennz Med Spa, Pllc is 418 S Wagner Rd, Ann Arbor, MI and can be reached out via phone at 734-355-3566.

Location: 418 S Wagner Rd, Ann Arbor, MI, 48103-9743
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083310312
Provider Name
Dr. Revivajennz Med Spa, Pllc
Credential
Provider Entity Type
Organization
Address
418 S Wagner Rd, Ann Arbor, MI, 48103-9743
Phone Number
734-355-3566
Fax Number
Provider Enumeration Date
02/07/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
418 S Wagner Rd
City
Ann Arbor
State
Michigan
Zip
48103-1944
Phone Number
734-355-3566
Fax Number
person
Provider Business Mailing Address Details
Address
418 S Wagner Rd
City
Ann Arbor
State
Michigan
Zip
48103-1944
Phone Number
734-355-3566
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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