Revitalize 3d

NPI #1568139269 in Provo, Utah

Provider Information

NPI Number: 1568139269
Entity Type: Organization
Organization Name: Revitalize 3d
Primary Specialty: Physical Therapist
Enumeration Date: Aug 30, 2021
Last Updated: Jun 2, 2022

Practice Location

Address: 184 W 400 N
City: Provo
State: Utah
ZIP Code: 84601-2855
Phone: (785) 477-2647

Authorized Official

Name: DR. BRIAN PATRICK COLLINS, DPT
Title: OWNER/CEO
Phone: (785) 477-2647

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist - Ergonomics — Ergonomics	2251E1200X
Physical Therapist - Geriatrics — Geriatrics	2251G0304X
Physical Therapist - Human Factors — Human Factors	2251H1300X
Physical Therapist - Sports — Sports	2251S0007X
Physical Therapist - Orthopedic — Orthopedic	2251X0800X
Physical Therapist	225100000X	Primary

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