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Organization

REVIVE PHYSICAL THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VINILA PEDDIBOYINA MPT (PHYSICAL THERAPY)
(703) 357-6161
Entity
Organization

Contact information

Practice address
5675 STONE RD STE 200, CENTREVILLE, VA 20120-1667
(703) 357-6161
Mailing address
23332 MINERVA DR, BRAMBLETON, VA 20148-6877

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
11/07/2025
Last updated
11/09/2025
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