Organization
REVOLUTION PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD L VALENTINE (OWNER)
(606) 521-4743
Entity
Organization
Contact information
Practice address
195 COMMERCIAL DR STE 100, LONDON, KY 40744-5234
(606) 657-5111
(606) 657-2354
Mailing address
195 COMMERCIAL DR STE 100, LONDON, KY 40744-5234
(606) 657-5111
(606) 657-2354
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100592450
—
KY
Enumeration date
12/28/2018
Last updated
08/13/2024
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