Organization
REVITALIZE 3D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN PATRICK COLLINS DPT (OWNER/CEO)
(785) 477-2647
Entity
Organization
Contact information
Practice address
184 W 400 N, PROVO, UT 84601-2855
(785) 477-2647
Mailing address
1427 S 680 W, PROVO, UT 84601-5544
(785) 477-2647
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251E1200X
Ergonomics Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251H1300X
Human Factors Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
08/30/2021
Last updated
06/02/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up