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General NPI Number Information
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NPI Number | 1043315641
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Entity Type | Organization
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Legal Business Name | RESTORED IMAGES INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 4116 NE VIVION RD
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City | KANSAS CITY
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State | MO
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Zip | 64119-2811
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Country | US
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Telephone | 816-454-2900
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Fax | 816-454-5881
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Provider Business Mailing Address
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Address Line | 4116 NE VIVION RD
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City | KANSAS CITY
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State | MO
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Zip | 64119-2811
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Country | US
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Telephone | 816-454-2900
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Fax | 816-454-5881
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. REBECCA WILLS
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Credential |
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Telephone | 816-454-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 14757222
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 14757222
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License Number State | MO
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