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General NPI Number Information
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NPI Number | 1508196502
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Entity Type | Organization
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Legal Business Name | RESTORATION REHABILITATION INC
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 10119 HIGHWAY 12 SW
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City | ROCHESTER
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State | WA
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Zip | 98579-8621
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Country | US
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Telephone | 360-273-4747
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Fax | 360-273-4747
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | FOX ISLAND
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State | WA
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Zip | 98333-0306
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Country | US
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Telephone | 360-273-4747
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Fax | 360-273-4747
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | LISA A SCHEUFFELE
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Credential | P.T.
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Telephone | 253-549-5668
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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 | PT00003851
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License Number State | WA
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