# SALT BEACH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922855592
- **Authorized official:** ANGELA M. BRANDON CERTIFIED (HALOTHERAPIST)
- **Authorized official phone:** (336) 970-8544

## Contact information

- **Practice address:** 3570 CLEMMONS RD STE A, CLEMMONS, NC 27012-8044
- **Practice address phone:** (336) 293-4598
- **Mailing address:** 3570 CLEMMONS RD STE A, CLEMMONS, NC 27012-8044
- **Mailing address phone:** (336) 293-4598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/02/2024
- **Last updated:** 05/02/2024