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

Revived Vitality

Organization Clinic/Center · NPI 1992588750

Revived Vitality is a Clinic/Center in Myrtle Beach, South Carolina. Works from 2 locations. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1301 48th Ave N # A-2
Myrtle Beach, SC 29577-5427
Phone: (843) 580-3694
Show map & directions

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

Additional practice locations (1)

  • 606 Bald Eagle Dr Ste 201, Marco Island, FL 34145-2731 — (843) 855-2299

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1992588750
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennings Perry — Owner/Provider · (843) 855-2299
NPI enumeratedAugust 16, 2023
Last updated in NPPESAugust 16, 2023
Certification dateAugust 16, 2023
Mailing address606 Bald Eagle Dr Ste 201, Marco Island, FL 34145-2731

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