Healthcare Provider Details

I. General information

NPI: 1245657576
Provider Name (Legal Business Name): RESTORATIVE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 MARINER BLVD
SPRING HILL FL
34609-2469
US

IV. Provider business mailing address

4121 MARINER BLVD
SPRING HILL FL
34609-2469
US

V. Phone/Fax

Practice location:
  • Phone: 352-340-5924
  • Fax: 352-340-5926
Mailing address:
  • Phone: 352-340-5924
  • Fax: 352-340-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. JAMES HALLATT
Title or Position: PRESIDENT
Credential: DPT
Phone: 352-340-5924