NPI | 1538721907 |
---|---|
Doing Business As | REVOLUTION PERFORMANCE PHYSICAL THERAPY |
Former Legal Business Name | REVOLUTION SPORTS PHYSICAL THERAPY AND PERFORMANCE |
Entity Type | Organization |
Authorized Contact | MATTHEW DAVID BLEVINS CEO/Owner 813-838-2510 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
2251X0800X Physical Therapist, Orthopedic | |
225200000X Physical Therapy Assistant | |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2019-07-05 |
Last Update Date | 2021-06-14 |