Provider Demographics
NPI:1467825182
Name:REST-MOORE INC.
Entity Type:Organization
Organization Name:REST-MOORE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRACLE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:606-302-4309
Mailing Address - Street 1:1632 CUMBERLAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1378
Mailing Address - Country:US
Mailing Address - Phone:606-302-4309
Mailing Address - Fax:606-766-0808
Practice Address - Street 1:1632 CUMBERLAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1378
Practice Address - Country:US
Practice Address - Phone:606-302-4309
Practice Address - Fax:606-766-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic