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General NPI Number Information
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NPI Number | 1316659626
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL RESTORATIONS LLC
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1200 BROAD ST STE 108
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City | DURHAM
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State | NC
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Zip | 27705-3573
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Country | US
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Telephone | 919-802-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BROAD ST STE 108
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City | DURHAM
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State | NC
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Zip | 27705-3573
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Country | US
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Telephone | 919-802-8020
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Fax | 919-251-9275
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Authorized Official
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Title or Position | PRINCIPLE/MANAGER
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Name | JENNIFER ROBINSON
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Credential |
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Telephone | 919-802-8020
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 229N00000X
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Taxonomy Name | Anaplastologist
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License Number |
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License Number State |
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