Revive Infusion Clinic, LLC
NPI #1457226789 in Eagle River, Alaska
Provider Information
- NPI Number
- 1457226789
- Entity Type
- Organization
- Organization Name
- Revive Infusion Clinic, LLC
- Primary Specialty
- Clinic/Center - Infusion Therapy
- Enumeration Date
- Oct 7, 2025
- Last Updated
- Nov 19, 2025
Practice Location
- Address
- 19332 WAR ADMIRAL RD
- City
- Eagle River
- State
- Alaska
- ZIP Code
- 99577-8482
- Phone
- (417) 793-3935
Authorized Official
- Name
- MR. MICHAEL JOSEPH SHANNON, RN
- Title
- OWNER
- Phone
- (417) 793-3935
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
| Clinic/Center - Infusion Therapy — Infusion Therapy |
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