Healthcare Provider Details

I. General information

NPI: 1578626248
Provider Name (Legal Business Name): REVOLUTION REHABILITATION P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 PRINTERS PKWY SUITE 125
COLORADO SPRINGS CO
80910-6100
US

IV. Provider business mailing address

155 PRINTERS PKWY SUITE 125
COLORADO SPRINGS CO
80910-6100
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-8622
  • Fax: 719-635-8619
Mailing address:
  • Phone: 719-635-8622
  • Fax: 719-635-8619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number5237
License Number StateCO

VIII. Authorized Official

Name: KAMBER LEE ARBINI
Title or Position: OWNER
Credential:
Phone: 719-635-8622