Organization
RESTORE MEDICAL GROUP HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN BARRIEAU (OWNER)
(970) 729-2727
Entity
Organization
Contact information
Practice address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(720) 678-9868
(720) 678-9860
Mailing address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(970) 729-2727
(720) 678-9860
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/31/2022
Last updated
11/25/2022
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