Organization
STICKS OF LYFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTELLE D GREGORY (OWNER)
(804) 324-6822
Entity
Organization
Contact information
Practice address
92 HENRICO ST, PETERSBURG, VA 23803-3668
(804) 324-6822
Mailing address
84 SOUTHGATE SQ # 1103, COLONIAL HEIGHTS, VA 23834-3611
(804) 324-6822
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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