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Organization
REVIVE PHYSICAL THERAPY
Active
Organization
REVIVE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HORACE VERNON PIGFORD III PT (PRESIDENT)
(910) 789-4770
Entity
Organization
Contact information
Practice address
904 S WALKER ST STE B, BURGAW, NC 28425-5008
(910) 789-4770
(910) 672-7622
Mailing address
PO BOX 1799, BURGAW, NC 28425-1799
(910) 789-4770
(910) 672-7622
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P12005
NC
Other
Enumeration date
02/13/2012
Last updated
06/27/2018
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