Provider Demographics
NPI:1861849077
Name:RESTORE MEDICAL INC.
Entity Type:Organization
Organization Name:RESTORE MEDICAL INC.
Other - Org Name:RESTORE ORTHOTICS AND PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KATI
Authorized Official - Middle Name:
Authorized Official - Last Name:AUXIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-523-7670
Mailing Address - Street 1:2147 COURT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2531
Mailing Address - Country:US
Mailing Address - Phone:530-605-4292
Mailing Address - Fax:530-605-4296
Practice Address - Street 1:3125 COFFEE RD STE 2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-1768
Practice Address - Country:US
Practice Address - Phone:209-846-3148
Practice Address - Fax:209-408-8130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORE MEDICAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-17
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier