Provider Demographics
NPI:1568058824
Name:RESTORATIVE PHYSICAL THERAPY & CORE WELLNESS INC
Entity Type:Organization
Organization Name:RESTORATIVE PHYSICAL THERAPY & CORE WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:859-309-1766
Mailing Address - Street 1:1795 ALYSHEBA WAY STE 5103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2473
Mailing Address - Country:US
Mailing Address - Phone:859-309-1766
Mailing Address - Fax:859-309-1854
Practice Address - Street 1:1795 ALYSHEBA WAY STE 5103
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2473
Practice Address - Country:US
Practice Address - Phone:859-309-1766
Practice Address - Fax:859-309-1854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center