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Organization
RESTORATION HEALTH LP
Active
Organization
RESTORATION HEALTH LP
Active
Other names
Restoration Health PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE L WORLEY (OFFICE MANAGER)
(817) 410-7773
Entity
Organization
Contact information
Practice address
2421 IRA E WOODS AVE STE 101, GRAPEVINE, TX 76051-3907
(817) 410-7773
(817) 421-5440
Mailing address
PO BOX 3183, GRAPEVINE, TX 76099-3183
(817) 410-7773
(817) 421-5440
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1148280
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049PK
BCBS GROUP NUMBER
TX
01
—
TXB131051
MEDICARE GROUP
TX
Enumeration date
10/16/2006
Last updated
09/03/2013
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