# RESTORE WELLNESS AND AESTHETICS

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

## Provider details

- **NPI number:** 1356108906
- **Authorized official:** CYNTHIA HOLTON APRN (OWNER)
- **Authorized official phone:** (912) 294-6712

## Contact information

- **Practice address:** 1811 MANNING DR, VIDALIA, GA 30474-8921
- **Practice address phone:** (912) 733-4555
- **Practice address fax:** (912) 575-6927
- **Mailing address:** 1811 MANNING DR, VIDALIA, GA 30474-8921
- **Mailing address phone:** (912) 733-4555
- **Mailing address fax:** (912) 575-6927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/29/2024
- **Last updated:** 04/23/2025