# REVAMP THERAPY L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932498649
- **Authorized official:** NASH BUTRIMAS (MANAGER/PHYSICAL THERAPIST)
- **Authorized official phone:** (352) 226-2400

## Contact information

- **Practice address:** 1935 SAN MARIE DR N, JACKSONVILLE, FL 32217-2348
- **Practice address phone:** (352) 226-2400
- **Mailing address:** 1935 SAN MARIE DR N, JACKSONVILLE, FL 32217-2348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | PT222863 | FL | Yes |

## Other

- **Enumeration date:** 04/04/2011
- **Last updated:** 04/18/2011