Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Revive Neurorecovery Center Clt LLC

Organization Physical Therapist · NPI 1679201123

Revive Neurorecovery Center Clt LLC provides Physical Therapist services 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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