Organization · Type 2 NPI
Restoration Clinic
Primary Care Nurse Practitioner · Decatur, TN
NPI number
1174226757
Active
Practice location
16850 State Highway 58 South, Suite A
Decatur, TN 37322
Fax (423) 454-0125
Mailing address
16850 State Highway 58 S Ste A
Decatur, TN 37322-5259
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | None listed |
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
About NPI 1174226757
Restoration Clinic's National Provider Identifier is 1174226757, issued on Mar 23, 2023. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Decatur, TN. The record was last updated on Feb 6, 2024.