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General NPI Number Information
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NPI Number | 1326953233
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Entity Type | Organization
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Legal Business Name | BONE RESTORATION AND WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 8556 E 101ST ST STE G
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City | TULSA
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State | OK
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Zip | 74133-7036
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Country | US
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Telephone | 813-294-2208
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Fax |
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Provider Business Mailing Address
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Address Line | 8556 E 101ST ST STE G
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City | TULSA
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State | OK
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Zip | 74133-7036
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Country | US
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Telephone | 813-294-2208
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Fax |
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | KRISTEN BALL
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Credential | PA
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Telephone | 208-315-1340
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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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