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Organization
RESTORATION CLINIC
Active
Organization
RESTORATION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENGLISH PAIGE ROBERTS (OWNER)
(423) 506-3781
Entity
Organization
Contact information
Practice address
17619 STATE HIGHWAY 58 N STE C, DECATUR, TN 37322-7882
(423) 506-3781
Mailing address
PO BOX 1094, DECATUR, TN 37322-1094
(423) 506-3781
(423) 454-0178
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
TN
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/02/2014
Last updated
04/08/2024
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