| Organization Name: | REVIVE BOOST REBUILD PHYSICAL THERAPY LLC |
| NPI Number: | 1194192294 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID J CONTI (OWNER) |
| Mailing Address: | 1300 Corporation Pkwy Ste B Raleigh |
| State: | NC US |
| Postal Code: | 276101362 |
| Phone Number: | 9199177729 |
| Fax Number: | 9194004178 |
| NPI Enumeration Date: | 08/25/2015 |
| NPI Last Update Date: | 03/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 13508 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |