Organization
PT REVOLUTION PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON COLLIN (OWNER)
(530) 307-3316
Entity
Organization
Contact information
Practice address
2038 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-6499
(530) 208-9910
(530) 285-2001
Mailing address
2038 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-6499
(530) 208-9910
(530) 285-2001
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
04/26/2023
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