Provider Demographics
NPI:1730655846
Name:RESTORE THERAPY SERVICES, LTD.
Entity Type:Organization
Organization Name:RESTORE THERAPY SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-942-6820
Mailing Address - Street 1:245 CAHABA VALLEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2217
Mailing Address - Country:US
Mailing Address - Phone:205-942-6820
Mailing Address - Fax:
Practice Address - Street 1:40890 ALABAMA HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:MOUNDVILLE
Practice Address - State:AL
Practice Address - Zip Code:35474
Practice Address - Country:US
Practice Address - Phone:205-314-7227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORE THERAPY SERVICES, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-16
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty