OrganizationRevive Health Center And SpaChiropractorChiropractic ProvidersPractice Address6875 Hickory Rd Ste 110, Woodstock, GA 30188-2011(770) 345-1111PECOS EnrollmentBased on the most recent information from CMS, provider Revive Health Center And Spa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1477749067Provider TypeOrganizationFull NameRevive Health Center And SpaSubpartNoEnumeration Date9/18/2007Last Updated10/19/2016Contact InformationPractice LocationPractice Address6875 Hickory Rd Ste 110, Woodstock, GA 30188-2011Phone(770) 345-1111Fax(770) 345-1788Mailing LocationMailing Address6875 Hickory Rd Ste 110, Woodstock, GA 30188-2011Phone(770) 345-1111Fax(770) 345-1788Authorized OfficialNameBaxter, Kellie (Chiropractor/Owner)Phone(770) 345-1111Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseCHIR007723Georgia