Organization
REVIVE PHYSICAL THERAPY & TRAINING LLC
Active
Organization
REVIVE PHYSICAL THERAPY & TRAINING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CUMMINS PT, DPT (OWNER/MANAGER)
(913) 522-9971
Entity
Organization
Contact information
Practice address
3912 SLATE DR, CHAMPAIGN, IL 61822-4200
(913) 522-9971
Mailing address
3912 SLATE DR, CHAMPAIGN, IL 61822-4200
(913) 522-9971
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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