Provider Demographics
NPI:1184387235
Name:REVIVE INTEGRATIVE HEALTH LLC.
Entity type:Organization
Organization Name:REVIVE INTEGRATIVE HEALTH LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROST
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:785-577-5736
Mailing Address - Street 1:645 E IRON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2697
Mailing Address - Country:US
Mailing Address - Phone:785-577-5736
Mailing Address - Fax:785-200-3765
Practice Address - Street 1:645 E IRON AVE STE C
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2697
Practice Address - Country:US
Practice Address - Phone:785-577-5736
Practice Address - Fax:785-200-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty