Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Wound Care Ga LLC

Organization General Practice Physician · NPI 1548082274

Revive Wound Care Ga LLC is a General Practice Physician in Clarkston, Georgia. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

980 Rowland St Ste 5140 #1111
Clarkston, GA 30021
Phone: (951) 760-6216
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Home Health Agency Taxonomy 251E00000X

Record details

NPI number1548082274
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Davis — Manager · (951) 760-6216
NPI enumeratedOctober 24, 2024
Last updated in NPPESOctober 24, 2024
Certification dateOctober 17, 2024
Mailing address980 Rowland St, Ste 5140 #1111, Clarkston, GA 30021