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General NPI Number Information
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NPI Number | 1407196504
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Entity Type | Organization
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Legal Business Name | RESTORATION PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 47 CRESTWOOD RD STE 2B
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City | KAYSVILLE
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State | UT
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Zip | 84037-1445
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Country | US
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Telephone | 801-444-3440
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Fax | 801-444-3413
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Provider Business Mailing Address
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Address Line | 47 CRESTWOOD RD STE 2B
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City | KAYSVILLE
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State | UT
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Zip | 84037-1445
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Country | US
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Telephone | 801-444-3440
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Fax | 801-444-3413
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Authorized Official
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Title or Position | OWNER
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Name | ADAM MORRIS
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Credential | PT
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Telephone | 801-549-7352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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