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General NPI Number Information
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NPI Number | 1497580393
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Entity Type | Organization
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Legal Business Name | RESTORE MUSCLE AND JOINT SL, LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 4225 BAYLESS AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63123-7513
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Country | US
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Telephone | 314-544-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 4119 NW BARRY RD
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City | KANSAS CITY
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State | MO
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Zip | 64154-1100
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Country | US
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Telephone | 816-452-4488
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENDRA L PEARSON
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Credential | DC
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Telephone | 816-452-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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