MEDICARE: RESTORATIVE THERAPY OUTPATIENT, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1285060863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATIVE THERAPY OUTPATIENT, INC

Provider Business Mailing Address
First Line	:	4121 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2469
Country	:	US
Telephone Number	:	352-340-5924
Fax Number	:	352-340-5926

Provider Business Practice Location Address
First Line	:	4121 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2469
Country	:	US
Telephone Number	:	352-340-5924
Fax Number	:	352-340-5926

Authorized Official
Title or Position	:	ADMINISTRATOR & V.P.
Name	:	JUSTIN SPIEGEL
Credential	:	P.T.
Telephone Number	:	352-340-5924

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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