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General NPI Number Information
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NPI Number | 1750760369
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Entity Type | Organization
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Legal Business Name | WOMEN RESTORE LLC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 1171 EXPRESSWAY LN
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City | SPANISH FORK
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State | UT
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Zip | 84660-1331
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Country | US
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Telephone | 801-787-7007
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Fax | 801-210-2989
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Provider Business Mailing Address
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Address Line | 1171 EXPRESSWAY LN
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City | SPANISH FORK
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State | UT
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Zip | 84660-1331
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Country | US
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Telephone | 801-787-7007
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Fax | 801-210-2989
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MISTY G GALBRAITH
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Credential |
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Telephone | 801-787-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | UT
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