Revive Physical Therapy, LLC
Physical Therapist in Gunnison, CO. Organization (NPI-2).
NPI number1962044735
StatusActive
Last updated in NPPESJan 7, 2020
Details
- NPI
- 1962044735
- Entity type
- Organization (NPI-2)
- Legal business name
- Revive Physical Therapy, LLC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2019
- Certification date
- Jan 7, 2020
- Last updated
- Jan 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
980 Ute LnGunnison, CO 81230-8704
Phone 719-251-8593
Mailing address
980 Ute LnGunnison, CO 81230-8704
Phone 719-251-8593
Authorized official
Taren Colleen Frazier
Physical Therapist
7192518593
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