Organization
REVOLUTION REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALVATORE J MINICOZZI (MEMBER MANAGER)
(404) 531-9914
Entity
Organization
Contact information
Practice address
5871 GLENRIDGE DR NE, SUITE 115, SANDY SPRINGS, GA 30328-5375
(404) 531-9914
Mailing address
5871 GLENRIDGE DR NE, SUITE 115, SANDY SPRINGS, GA 30328-5375
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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