Healthcare Provider Details

I. General information

NPI: 1811402563
Provider Name (Legal Business Name): RESTORATIVE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EXTON CMNS
EXTON PA
19341-2449
US

IV. Provider business mailing address

201 EXTON CMNS
EXTON PA
19341-2449
US

V. Phone/Fax

Practice location:
  • Phone: 610-363-2897
  • Fax:
Mailing address:
  • Phone: 610-363-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberDC005850L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005850L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ELIZABETH K CARTER
Title or Position: OWNER
Credential:
Phone: 610-363-2897