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Organization
REVIVE REHAB PLUS LLC
Active
Organization
REVIVE REHAB PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVYA REDDY PUNURU PT (MANAGING MEMBER)
(619) 203-9674
Entity
Organization
Contact information
Practice address
25017 WHITE SANDS DR, CHANTILLY, VA 20152-4153
(619) 203-9674
Mailing address
25017 WHITE SANDS DR, CHANTILLY, VA 20152-4153
(619) 203-9674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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