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General NPI Number Information
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NPI Number | 1407408198
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Entity Type | Organization
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Legal Business Name | REVIVE OUTPATIENT SERVICES, LLC.
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 37824 VAN DYKE AVE
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-1840
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Country | US
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Telephone | 269-589-9659
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Fax | 586-314-0181
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Provider Business Mailing Address
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Address Line | 49578 E CENTRAL PARK
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-2412
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Country | US
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Telephone | 269-589-9659
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Fax | 586-314-0181
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Authorized Official
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Title or Position | OWNER
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Name | MR. KAUSHIK JOSHI
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Credential | RPT, MBA, DPT
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Telephone | 269-589-9659
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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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