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

Johnna Revis, PTA

Individual provider Physical Disabilities Residential Treatment Facility · NPI 1205202413

Johnna Revis, PTA is a Physical Disabilities Residential Treatment Facility in Gray Court, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2015
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

5768 Highway 14
Gray Court, SC 29645-6764
Phone: (864) 872-2116
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Disabilities Residential Treatment Facility (primary) Taxonomy 320700000X · Licence 1771 (SC)

Record details

NPI number1205202413
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedAugust 12, 2015
Last updated in NPPESAugust 12, 2015
Mailing address5768 Highway 14, Gray Court, SC 29645-6764