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General NPI Number Information
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NPI Number | 1568058824
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Entity Type | Organization
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Legal Business Name | RESTORATIVE PHYSICAL THERAPY & CORE WELLNESS INC
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 1795 ALYSHEBA WAY STE 5103
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City | LEXINGTON
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State | KY
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Zip | 40509-2473
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Country | US
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Telephone | 859-309-1766
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Fax | 859-309-1854
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Provider Business Mailing Address
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Address Line | 1795 ALYSHEBA WAY STE 5103
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City | LEXINGTON
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State | KY
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Zip | 40509-2473
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Country | US
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Telephone | 859-309-1766
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Fax | 859-309-1854
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY MARIE HAMILTON
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Credential | PT
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Telephone | 859-309-1766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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