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NPI Code Detail

MEDICARE: HOPE REVENAUGH DPT

MEDICARE: HOPE REVENAUGH DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP24588NC

General Provider Information

NPI Number : 1205794005
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOPE REVENAUGH DPT
Provider Business Mailing Address
First Line : 3643 N ROXBORO ST
Second Line :
City : DURHAM
State : NC
Zip : 27704-2702
Country : US
Telephone Number : 919-470-4000
Fax Number :
Provider Business Practice Location Address
First Line : 3643 N ROXBORO ST
Second Line :
City : DURHAM
State : NC
Zip : 27704-2702
Country : US
Telephone Number : 919-470-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ HOPE REVENAUGH DPT” Practice Location

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