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General NPI Number Information
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NPI Number | 1134984362
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Entity Type | Organization
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Legal Business Name | RESTORED LIFE TAXI
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 302 S REED RD
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City | KOKOMO
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State | IN
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Zip | 46901-4900
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Country | US
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Telephone | 765-450-4928
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Fax |
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Provider Business Mailing Address
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Address Line | 2155 N 100 E
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City | TIPTON
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State | IN
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Zip | 46072-8490
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Country | US
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Telephone | 765-450-4928
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | NICHOLAS SALVATO
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Credential |
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Telephone | 765-450-4928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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