Organization
RESTORE FUNCTIONAL RESTORATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY RICHTER BODE (OWNER/COO)
(602) 403-9711
Entity
Organization
Contact information
Practice address
20002 N 19TH AVE # B100, PHOENIX, AZ 85027-4250
(602) 714-1408
(888) 468-7614
Mailing address
20002 N 19TH AVE # B100, PHOENIX, AZ 85027-4250
(602) 714-1408
(888) 468-7614
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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