Individual
CHRISTINA LOCKLEAR REVELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
293 OLMSTED BLVD STE 7, PINEHURST, NC 28374-9191
(910) 295-3344
(910) 295-3165
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104036
NC
Other
Enumeration date
02/28/2007
Last updated
01/31/2025
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