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General NPI Number Information
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NPI Number | 1225242308
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Entity Type | Organization
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Legal Business Name | RESTORED HEALTH INC.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 483 INDIAN TRAIL LILBURN RD NW
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City | LILBURN
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State | GA
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Zip | 30047-3717
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Country | US
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Telephone | 770-923-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 590 BARONY CV
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City | SUWANEE
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State | GA
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Zip | 30024-3085
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Country | US
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Telephone | 678-699-1332
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Fax | 678-482-1134
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Authorized Official
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Title or Position | M.D.
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Name | KIRPICH JOSEPH
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Credential |
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Telephone | 678-699-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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