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General NPI Number Information
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NPI Number | 1689547424
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Entity Type | Organization
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Legal Business Name | RELIVE IN-HOME PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 12516 OVER RIDGE RD
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City | POTOMAC
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State | MD
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Zip | 20854-2441
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Country | US
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Telephone | 540-490-0467
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Fax |
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Provider Business Mailing Address
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Address Line | 12516 OVER RIDGE RD
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City | POTOMAC
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State | MD
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Zip | 20854-2441
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Country | US
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Telephone | 540-490-0467
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Fax |
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Authorized Official
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Title or Position | OWNER PROVIDER AUTHORIZED OFFICIAL
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Name | VIDHYA RAJAGOPAL
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Credential | P.T.
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Telephone | 540-490-0467
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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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