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General NPI Number Information
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NPI Number | 1285553404
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Entity Type | Organization
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Legal Business Name | RELEVATE PERFORMANCE PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 21 HOLMES CIR
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City | FARMINGTON
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State | CT
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Zip | 06032-2507
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Country | US
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Telephone | 860-809-5228
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Fax |
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Provider Business Mailing Address
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Address Line | 21 HOLMES CIR
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City | FARMINGTON
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State | CT
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Zip | 06032-2507
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Country | US
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Telephone | 860-809-5228
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | JORDAN NIHOUL
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Credential | DPT, ATC
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Telephone | 575-642-2395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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