| Revision Health Services, Pllc | |
|
131 Valley Grove Dr, Ponte Vedra, FL 32081-6165 | |
| (309) 267-9873 | |
| Not Available |
| Full Name | Revision Health Services, Pllc |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Physical Therapy |
| Location | 131 Valley Grove Dr, Ponte Vedra, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659994911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
| Provider Name | Michael Derry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285015024 PECOS PAC ID: 2163738790 Enrollment ID: I20200630000462 |
| Provider Name | Jackie B Blankenship |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174208151 PECOS PAC ID: 6901269885 Enrollment ID: I20230824002629 |
| Provider Name | Christopher Pregony |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639945447 PECOS PAC ID: 4789034562 Enrollment ID: I20231219003477 |
| Provider Name | Hannah Rawlings |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508330200 PECOS PAC ID: 3274905666 Enrollment ID: I20240523001632 |
| Mailing Address | Practice Location Address |
|---|---|
| Revision Health Services, Pllc 908 W 1st St, Spring Valley, IL 61362-1135 Ph: (309) 267-9873 | Revision Health Services, Pllc 131 Valley Grove Dr, Ponte Vedra, FL 32081-6165 Ph: (309) 267-9873 |