Organization
RESTART CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK L HOLLINS MD (MEMBER/MANAGER)
(859) 264-7722
Entity
Organization
Contact information
Practice address
129 EDGEWOOD PLAZA DR, NICHOLASVILLE, KY 40356-1818
(859) 264-7722
Mailing address
2112 CAVE HILL LN, LEXINGTON, KY 40513-1055
(859) 224-8835
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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