Organization
REVIVAL MEDICAL WEIGHT LOSS CLINIC
Active
Organization
REVIVAL MEDICAL WEIGHT LOSS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY NEALEY WAIWRIGHT (CEO)
(910) 679-4312
Entity
Organization
Contact information
Practice address
2245 STANTONSBURG RD STE A, GREENVILLE, NC 27834-2868
(252) 653-5022
Mailing address
1508 MILITARY CUTOFF RD STE 203, WILMINGTON, NC 28403-5730
(910) 679-4312
Taxonomy
Speciality
Code
Description
License number
State
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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