Provider Demographics
NPI:1407417769
Name:RESTORATION HEALTH & CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:RESTORATION HEALTH & CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELBE
Authorized Official - Middle Name:JAEDE
Authorized Official - Last Name:DARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-789-2773
Mailing Address - Street 1:805 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-3315
Mailing Address - Country:US
Mailing Address - Phone:785-789-2773
Mailing Address - Fax:
Practice Address - Street 1:805 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-3315
Practice Address - Country:US
Practice Address - Phone:785-789-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty