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General NPI Number Information
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NPI Number | 1609691385
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Entity Type | Organization
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Legal Business Name | RESTORATION PRIMARY CARE PLLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 1385 S COLLEGE ST STE 1
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City | WINCHESTER
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State | TN
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Zip | 37398-2414
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Country | US
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Telephone | 931-919-4087
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Fax | 949-703-8231
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | WINCHESTER
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State | TN
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Zip | 37398-0010
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Country | US
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Telephone | 931-919-4087
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Fax | 949-703-8231
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON FOSTER
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Credential |
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Telephone | 931-919-4087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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