Organization
REVITALIZE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GINA HATFIELD MOT, OTR/L (OWNER)
(580) 579-8114
Entity
Organization
Contact information
Practice address
523 N WASHINGTON AVE, DURANT, OK 74701-3403
(580) 634-2423
Mailing address
1802 JUANITAS LN, KINGSTON, OK 73439-5477
(580) 579-8114
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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