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Organization
REVIVE PHYSICAL THERAPY LLC
Active
Organization
REVIVE PHYSICAL THERAPY LLC
Active
Parent organization
REVIVE PHYSICAL THERAPY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
REVIVE PHYSICAL THERAPY LLC
Authorized official
RENUKA JAIN DPT (OWNER)
(781) 266-6621
Entity
Organization
Contact information
Practice address
4920 WATERLOO RD STE A, ELLICOTT CITY, MD 21043-6888
(443) 438-0586
(443) 364-3039
Mailing address
10300B BALTIMORE NATIONAL PIKE, ELLICOTT CITY, MD 21042-2128
(443) 438-0586
(443) 364-3039
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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