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Organization
REVOLUTION PERFORMANCE, LLC
Active
Organization
REVOLUTION PERFORMANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN A QUEEN PT, DPT, CSCS, PN1 (OWNER/CEO)
(618) 670-3788
Entity
Organization
Contact information
Practice address
4516 KENNY RD STE B, COLUMBUS, OH 43220-3786
(614) 859-2785
Mailing address
2759 BERLIN STATION RD, DELAWARE, OH 43015-9406
(618) 670-3788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/03/2022
Last updated
04/03/2022
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