=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194997668
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESTORATIVE HEALTH SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2008
-----------------------------------------------------
Last Update Date | 01/18/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 397 WALLACE RD STE 206
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37211-4854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-327-1100
-----------------------------------------------------
Fax | 615-327-1141
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1272 GARRISON DR STE 307
-----------------------------------------------------
City | MURFREESBORO
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37129-3177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-890-2160
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT, OWNER
-----------------------------------------------------
Name | AARON SORENSEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-890-2160
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------