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General NPI Number Information
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NPI Number | 1134044357
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Entity Type | Organization
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Legal Business Name | RESTORED WELLNESS & RECOVERY, PLLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 7601 LOST TREE RD
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City | WILMINGTON
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State | NC
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Zip | 28411-9159
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Country | US
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Telephone | 910-227-9956
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Fax | 910-202-6475
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Provider Business Mailing Address
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Address Line | 7601 LOST TREE RD
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City | WILMINGTON
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State | NC
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Zip | 28411-9159
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Country | US
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Telephone | 910-227-9956
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Fax | 910-202-6475
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANGELA BOOTH
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Credential | PA-C
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Telephone | 910-227-9956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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