Organization
REVIVE BEAUTY & DRIP LOUNGE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRYSTAL GAMMON NP (OWNER/OPERATOR)
(434) 429-2383
Entity
Organization
Contact information
Practice address
906 S MAIN ST, BURLINGTON, NC 27215-5757
(336) 935-1240
(336) 234-1020
Mailing address
PO BOX 116, SEDALIA, NC 27342-0116
(336) 266-7899
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
04/18/2023
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