| Revive Clinic And Iv Therapy Llc | |
|
5631 Burke Centre Pkwy Ste C Burke VA 22015-2234 | |
| (703) 200-1015 | |
| Not Available |
| Full Name | Revive Clinic And Iv Therapy Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5631 Burke Centre Pkwy Ste C, Burke, Virginia |
| Authorized Official Name and Position | Michelle Butler (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9169094910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Clinic And Iv Therapy Llc 5631 Burke Centre Pkwy Ste C Burke VA 22015-2234 Ph: () - | Revive Clinic And Iv Therapy Llc 5631 Burke Centre Pkwy Ste C Burke VA 22015-2234 Ph: (703) 200-1015 |
| NPI Number | 1578249942 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 09/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578249942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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