Organization
REVIVE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BLAIRE STANLEY M.S./CCC-SLP (ADMINISTRATOR)
(561) 247-7337
Entity
Organization
Contact information
Practice address
2151 45TH STREET, SUITE 104, WEST PALM BEACH, FL 33407-2028
(561) 247-7337
(561) 727-8908
Mailing address
2151 45TH STREET, SUITE 104, WEST PALM BEACH, FL 33407-2028
(561) 247-7337
(561) 727-8908
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2022
Last updated
06/26/2023
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