Organization
RESTORE HEALTHCARE
Active
Other names
Restore Healthcare Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS JARRETT (EXECUTIVE DIRECTOR)
(704) 559-9408
Entity
Organization
Contact information
Practice address
4350 MAIN ST, SUITE 211, HARRISBURG, NC 28075-7433
(704) 559-9408
(704) 731-0975
Mailing address
4258 HIGHWAY 49 S, UNIT 554, HARRISBURG, NC 28075-0345
(704) 559-9408
(704) 731-0975
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
133VN1005X
Renal Nutrition Registered Dietitian
—
NC
163WC0400X
Case Management Registered Nurse
Primary
—
NC
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
REHABILITATIVE
BLUE CROSS BLUE SHIELD
NC
Enumeration date
04/19/2013
Last updated
06/29/2015
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