Revive Physical Therapy, LLC
NPI #1982102620 in Gonzales, Louisiana
Provider Information
- NPI Number
- 1982102620
- Entity Type
- Organization
- Organization Name
- Revive Physical Therapy, LLC
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Jan 29, 2018
- Last Updated
- Jan 29, 2018
Practice Location
Authorized Official
- Name
- TANYA BROUSSARD
- Title
- CREDENTIALING SPECIALIST
- Phone
- (337) 704-5611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Physical Therapy — Physical Therapy |
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