# RESTORATION CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205248796
- **Authorized official:** ENGLISH PAIGE ROBERTS (OWNER)
- **Authorized official phone:** (423) 506-3781

## Contact information

- **Practice address:** 17619 STATE HIGHWAY 58 N STE C, DECATUR, TN 37322-7882
- **Practice address phone:** (423) 506-3781
- **Mailing address:** PO BOX 1094, DECATUR, TN 37322-1094
- **Mailing address phone:** (423) 506-3781
- **Mailing address fax:** (423) 454-0178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | TN | Yes |
| 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