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

Revive Physical Therapy LLC

Organization Physical Therapist · NPI 1679422968

Revive Physical Therapy LLC is a Physical Therapist in Ellicott City, Maryland. Works from 3 locations. Registered with an NPI since 2026.

In the registry since
2026
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

4920 Waterloo Rd Ste A
Ellicott City, MD 21043-6888
Phone: (443) 438-0586
Fax: (443) 364-3039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10316 Baltimore National Pike Ste A, Ellicott City, MD 21042-2128 — (443) 438-0586
  • 10300b Baltimore National Pike, Ellicott City, MD 21042-2128 — (443) 438-0586

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1679422968
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationRevive Physical Therapy LLC
Authorized official Renuka Jain — Owner · (781) 266-6621
NPI enumeratedJanuary 28, 2026
Last updated in NPPESJanuary 28, 2026
Certification dateJanuary 28, 2026
Mailing address10300b Baltimore National Pike, Ellicott City, MD 21042-2128

Other providers in Ellicott City