Revolution Health and Performance, Pllc

NPI #1215689641 in Springfield, Illinois

Provider Information

NPI Number: 1215689641
Entity Type: Organization
Organization Name: Revolution Health and Performance, Pllc
Primary Specialty: Physical Therapist
Enumeration Date: Jan 26, 2022
Last Updated: Jan 26, 2022

Practice Location

Address: 192 WISTERIA DR
City: Springfield
State: Illinois
ZIP Code: 62711-9258
Phone: (913) 967-9215

Authorized Official

Name: DANIEL STATON REBECK, PT, DPT
Title: PHYSICAL THERAPIST
Phone: (913) 967-9215

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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