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Organization
REVIVAL REHAB, LLC
Active
Organization
REVIVAL REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MINEAR PT (OWNER/PHYSICAL THERAPIST)
(813) 842-3351
Entity
Organization
Contact information
Practice address
18625 LE DAUPHINE PL, LUTZ, FL 33558-2886
(813) 842-3351
Mailing address
18625 LE DAUPHINE PL, LUTZ, FL 33558-2886
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
08/26/2024
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