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Organization
REVOLUTION HEALTH AND PERFORMANCE, PLLC
Active
Organization
REVOLUTION HEALTH AND PERFORMANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL STATON REBECK PT, DPT (PHYSICAL THERAPIST)
(913) 967-9215
Entity
Organization
Contact information
Practice address
192 WISTERIA DR, SPRINGFIELD, IL 62711-9258
(913) 967-9215
Mailing address
192 WISTERIA DR, SPRINGFIELD, IL 62711-9258
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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