Organization
RESTORE 35
Active
Organization
RESTORE 35
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALLIE SHORT DC (OWNER)
(859) 583-3842
Entity
Organization
Contact information
Practice address
3735 PALOMAR CENTRE DR STE 280, LEXINGTON, KY 40513-1187
(859) 374-1994
Mailing address
3735 PALOMAR CENTRE DR STE 280, LEXINGTON, KY 40513-1187
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
Update your record
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