Organization
REVITALIZE PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN IGGULDEN PTA (OWNER)
(360) 448-3544
Entity
Organization
Contact information
Practice address
2102 E MCLOUGHLIN BLVD, VANCOUVER, WA 98661-4130
(360) 448-3544
Mailing address
2102 E MCLOUGHLIN BLVD, VANCOUVER, WA 98661-4130
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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