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General NPI Number Information
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NPI Number | 1194614248
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Entity Type | Organization
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Legal Business Name | RESURGENS, LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 528 VALLEY HILL RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2441
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Country | US
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Telephone | 678-712-3072
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21068
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City | BELFAST
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State | ME
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Zip | 04915-4107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ANCILLARY OPERATIONS EA
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Name | BOBBI REVETTI
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Credential |
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Telephone | 404-575-4901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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