| NPI | 1356158414 |
|---|---|
| Doing Business As | REVITALYZE PHYSIOTHERAPY |
| Entity Type | Organization |
| Authorized Contact | VITALY DVOSKIN Owner 917-604-8612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2025-01-29 |