MEDICARE: RESTORATION CONCEPTS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568794105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATION CONCEPTS, INC.

Provider Business Mailing Address
First Line	:	809 N LAFAYETTE ST
Second Line	:	SUITE A
City	:	SHELBY
State	:	NC
Zip	:	28150-3978
Country	:	US
Telephone Number	:	704-481-8379
Fax Number	:	704-481-8571

Provider Business Practice Location Address
First Line	:	809 N LAFAYETTE ST
Second Line	:	SUITE A
City	:	SHELBY
State	:	NC
Zip	:	28150-3978
Country	:	US
Telephone Number	:	704-481-8379
Fax Number	:	704-481-8571

Authorized Official
Title or Position	:	FINANCE/HR DIRECTOR
Name	:	SHEREE SMITH
Credential	:
Telephone Number	:	704-481-8379

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	12/15/2010

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Directions to “RESTORATION CONCEPTS, INC. ” Practice Location

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