Organization · Type 2 NPI
Revive Wellness of Kennesaw LLC
General Practice Physician · Kennesaw, GA
NPI number
1033049390
Active
Practice location
2819 Dallas St NW
Kennesaw, GA 30144-2705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Another provider at this address
Other general practice physician providers in Kennesaw
About NPI 1033049390
Revive Wellness of Kennesaw LLC's National Provider Identifier is 1033049390, issued on May 20, 2026. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Kennesaw, GA. The record was last updated on Jun 24, 2026.