Organization
REVIVAL PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL SAMONTE MONTEMAYOR PT (CEO)
(980) 276-3066
Entity
Organization
Contact information
Practice address
4116 SWINDON CT, CHARLOTTE, NC 28215-5355
(980) 230-3276
Mailing address
4116 SWINDON CT, CHARLOTTE, NC 28215-5355
(980) 230-3276
Taxonomy
Speciality
Code
Description
License number
State
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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