Organization · Type 2 NPI
Revive Ketamine Clinic, PLLC
Medical Specialty Clinic/Center · Bartlett, TN
Practice location
5820 Stage Rd
Bartlett, TN 38134-4518
Fax (901) 317-7899
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | None listed |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | None listed |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
2 other providers at this address
About NPI 1053984484
Revive Ketamine Clinic, PLLC's National Provider Identifier is 1053984484, issued on Jul 22, 2021. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Bartlett, TN. The record was last updated on Apr 15, 2024.