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General NPI Number Information
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NPI Number | 1306784012
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Entity Type | Organization
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Legal Business Name | REVIVE LYMPHATICS LLC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 510 E MAIN ST STE 1
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City | SOMERSET
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State | PA
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Zip | 15501-2198
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Country | US
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Telephone | 714-819-0158
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Fax |
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Provider Business Mailing Address
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Address Line | 510 E MAIN ST STE 1
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City | SOMERSET
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State | PA
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Zip | 15501-2198
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Country | US
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Telephone | 714-819-0158
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Fax |
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Authorized Official
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Title or Position | OWNER, OCCUPATIONAL THERAPIST
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Name | ELISE FRANCISCUS
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Credential | MOT-OTR/L, CLT
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Telephone | 714-819-0158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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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