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General NPI Number Information
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NPI Number | 1649032160
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Entity Type | Organization
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Legal Business Name | RESTORE OCCUPATIONAL THERAPY, PLLC
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 3223 S LOOP 289 STE 315
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City | LUBBOCK
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State | TX
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Zip | 79423-1333
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Country | US
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Telephone | 806-789-9659
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Fax |
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Provider Business Mailing Address
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Address Line | 3514 152ND ST
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City | LUBBOCK
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State | TX
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Zip | 79423-6306
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Country | US
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Telephone | 806-789-9659
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | JANDA S BISHOP
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Credential | OTR,MOT
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Telephone | 806-789-9659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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