Revive Neurorecovery Center Clt LLC
NPI #1679201123 in Fort Mill, South Carolina
Provider Information
- NPI Number
- 1679201123
- Entity Type
- Organization
- Organization Name
- Revive Neurorecovery Center Clt LLC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Aug 11, 2022
- Last Updated
- Feb 25, 2024
Practice Location
- Address
- 3463 HIGHWAY 21 STE 112
- City
- Fort Mill
- State
- South Carolina
- ZIP Code
- 29715-7210
- Phone
- (704) 900-3674
Authorized Official
- Name
- ASHLEY CLARK, DPT
- Title
- OWNER
- Phone
- (704) 900-3674
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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