# BIORESTORE LLC

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

## Provider details

- **NPI number:** 1801388558
- **Authorized official:** SCOTT G MARSTELLER M.D. (OWNER)
- **Authorized official phone:** (317) 578-1220

## Contact information

- **Practice address:** 10967 ALLISONVILLE RD STE 220, FISHERS, IN 46038
- **Practice address phone:** (317) 578-1220
- **Practice address fax:** (833) 228-1102
- **Mailing address:** 914 RANCH RD, CONNERSVILLE, IN 47331-1238
- **Mailing address phone:** (317) 578-1220
- **Mailing address fax:** (833) 228-1102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01068656A | IN | Yes |

## Other

- **Enumeration date:** 05/30/2018
- **Last updated:** 06/25/2018