Provider Demographics
NPI:1437537362
Name:RESTORE CHIROPRACTIC, L.L.C.
Entity Type:Organization
Organization Name:RESTORE CHIROPRACTIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-236-3835
Mailing Address - Street 1:26381 S TAMIAMI TRL STE 130
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7803
Mailing Address - Country:US
Mailing Address - Phone:806-236-3835
Mailing Address - Fax:
Practice Address - Street 1:26381 S TAMIAMI TRL STE 130
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7803
Practice Address - Country:US
Practice Address - Phone:806-236-3835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty