Organization
RESTORATION WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA M PETERSEN ANP (OWNER)
(907) 376-7300
Entity
Organization
Contact information
Practice address
5805 E COLUMBUS WAY, WASILLA, AK 99654-7831
(907) 376-7300
Mailing address
PO BOX 876089, WASILLA, AK 99687-6089
(907) 376-7300
(888) 977-2041
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1042971
AK
Other
Enumeration date
10/16/2016
Last updated
12/30/2016
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