Organization
RESTORE OF ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY BODE (MANAGING PARTNER)
(623) 209-5067
Entity
Organization
Contact information
Practice address
17431 N 71ST DR, SUITE 104, GLENDALE, AZ 85308-8598
(623) 209-5067
(623) 209-5065
Mailing address
17431 N 71ST DR, SUITE 104, GLENDALE, AZ 85308-8598
(623) 209-5067
(623) 209-5065
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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