Organization
RESTORE PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WARD HENNE PT (PRESIDENT)
(678) 491-4729
Entity
Organization
Contact information
Practice address
415 BELLFLOWER CT, ROSWELL, GA 30076-3369
(678) 491-4729
Mailing address
415 BELLFLOWER CT, ROSWELL, GA 30076-3369
(678) 491-4729
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT007124
GA
Other
Enumeration date
12/12/2010
Last updated
01/11/2011
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