Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Neurorecovery Center Clt LLC

Organization Physical Therapist · NPI 1679201123

Revive Neurorecovery Center Clt LLC is a Physical Therapist in Fort Mill, South Carolina. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3463 Highway 21 Ste 112
Fort Mill, SC 29715-7210
Phone: (704) 900-3674
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1679201123
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Clark — Owner · (704) 900-3674
NPI enumeratedAugust 11, 2022
Last updated in NPPESFebruary 25, 2024
Certification dateFebruary 25, 2024
Mailing address3463 Highway 21 Ste 112, Fort Mill, SC 29715-7210

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